AC 4361 PH/L ISL 90 1961 ANNUAL REPORT on the HEALTH AND SANITARY CONDITIONS of the METROPOLITAN BOROUGH OF ISLINGTON. VICTOR FREEMAN, m.r.c.s., l.r.c.p., d.p.h., Medical Officer of Health. i CANonbury 3388 Public Health Department, Town Hall, Islington, N. 1. TO THE MAYOR ALDERMEN AND COUNCILLORS OF THE METROPOLITAN BOROUGH OF ISLINGTON In presenting the Annual Report for 1961, I also have the honour of presenting my twenty-first Report as Medical Officer of Health of the Metropolitan Borough of Islington. Changes in the health conditions and sanitary circumstances in the Borough over the past generation have been very considerable in many directions nevertheless it remains the case that most improvements in the field of prevention are slower-moving and have to be viewed over a longer period than some of the changes which may be dramatic in the field of curative medicine 1961 was also Census year and at the time of this Report only total population figures were available, which have been given in this Report, The Census population, 228,833, was rather larger than would have been anticipated from the previous estimates made by the Registrar General. It can be presumed that local immigration might account for this result but the detailed breakdown of the Census figures which, it is anticipated, will become available some time in late 1962 should provide some interesting and necessary information not only in regard to population changes which have taken place since 1951, but in some degree to housing changes also The Islington birth-rate for the year has exceeded the "bulge " year of 1947 The relatively high birth-rate, therefore must be taken into consideration as a long term factor and not be regarded as a temporary difficult passing phase. Vital statistics, which are measurements of the health status of the Borough compare favourably with most other districts but there are some grey, if not exactly black spots, Health risks affecting very young children are relatively low especially considering the congested housing conditions in which a large number of infants in the Borough must be reared The favourable results can be taken as an indication of careful mothering under adverse circumstances, to which advice given through the Local Health Authority Child Welfare centres and by the Family Practioners and Hospitals make a major contribution The maternal deaths, however, for the year were in excess of the average and the analysis of the deaths given in the Report shows that five of the total of seven were probably due to induced abortions. It is apparent that the risks of such procedures are still not appreciated as they should be, or the risks are ignored under great emotional stress Islington is also an area where the proportion of deaths due to pneumonia and bronchitis is on the high side In view of the direct association of these forms of respiratory illness with atmospheric pollution progress with Smoke Control Areas is important This is referred to later. There is also a higher than average proportion of deaths due to cancer of the lung and bronchus in Islington. Deaths from this cause were slightly less in 1961, than in the previous year, but it is too early to say yet that the regular increase over the post-war years has now been reversed, If there had been 170 deaths in one year due to typhoid fever, or poliomyelitis or smallpox, there would quite rightly have been great public concern and activity The public still do not appear to realise that lung cancer is also a preventable disease On existing medical evidence approximately 90 per cent, of the 170 lung cancer deaths need not have occurred and this proportion, of course, is true of the country generally Also, lung cancer causes illness and mortality to this extent regularly every year, and not only in occasional outbreaks as would be expected with most infectious diseases Prevention, however, in this case is not dependent upon immunisation or vaccination given by doctors; it is preventable only by the personal decision of individuals either never to begin to smoke or to give up smoking. The Report also contains (page 11), for the first time an analysis of the deaths due to coronary disease of the heart. It will be seen from the table the increase in recent years in men from middle age onwards and to a lesser extent in more elderly women is apparent ii and such increases are in line with those in the country as a whole. In the field of infectious disease the Report refers in particular to a greater than average number of queries in regard to smallpox mainly due to speedy air travel between this country and parts of the world where smallpox is still common and to the record number of measles cases in 1961 which was the continuation of the outbreiak which commenced in the latter part of 1960. There were four confirmed cases of diphtheria, two were fatal but the circumstances of the outbreak detailed: in the Report were somewhat exceptional Poliomyelitis seems well on the way to becoming a rare illness. There was only one confirmed case during the year and there can be little doubt but that this situation would not have been achieved in the absence of active immunisation on a mass scale. Housing The social health and housing problems due to the preponderance if Islington houses being large elderly out of date and in multiple occupation have now receive some recognition in the provisions contained in the Housing Act, 1961 which came into force at the end of the year Local Authorities have been given greater powers than previously for dealing with adverse conditions in such types of houses including the provision of a code of management to ensure proper standards of management and powers by which the Local Authority may carry out work in default of the owner should this be necessary and to recover the costs incurred Whether the Act will be sufficient to assist with improvements being carried out on a major scale will however remain to be seen The personnel problem, due to an inadequate number of experienced Public Health Inspectors on the staff - a problem which has been mentioned unfortunately over the past few years in the Annual Reports - has not improved during the year The inadequacy of the technical staff must necessarily limit the amount of work which can be done by the Department both under the Housing Act and in the other branches of the Public Health Inspectors" work The Playford Road Clearance Area, comprising 44 houses was declared as such by the Council following representation and the Monsell Road Area of 14 houses was the subject of a Clearance Order confirmed, by the Minister of Housing and Local Government Legisl at ion and Problems Apart from the Housing Act, 1961, mentioned above the Factories Act, 1961. now supersedes the Factories Act of 1937 The Licensing Act, 1961, empowers Licensing Justices to deal with applications for licences for restaurants guest houses and clubs An application may be refused if the premises are not considered suitable or convenient. There has been a tendency for the establishment of clubs in private houses particularly in basements and the Licensing Act should assist in the control of such premises The Consumer Protection Act, 1961, replaces the Heating Appliances (Fireguards) Act 1952 and the Oil Burners (Standards) Act, 1960. but the Regulations made under the previous Acts are still in force Pollutior of the Atmof sphere In order that the survey of the Borough for declaration of Smoke Control Areas might be expedited the Council agreed to establish two Technical Assistants to help the Public Healtk Inspectors engaged on Clean Air Act duties The earlier programme has therefore been accelerated and the Report includes some information on the revised programme. Four Smoke Control Orders were made during the year, covering areas in the north and south of the Borough, and all the Orders were due to become operative in 1962. Atmospheric pollution and respiratory illness, particularly bronchitis have been shown to be closely associated The incidence of bronchitis in Islington has always been high and it is hoped that the diminution of atmospheric pollution through the gradual extension of Snoke control Areas in this and adjoining Boroughs will in course of time have a beneficial health effect Changes in air pollution are being carefully monitered through the Department's own instruments, and an additional pollution recording site has also been set up in the north the Borough by the scientific staff of the London County Council. Atmospheric pollution recording is carried out by the Department in close conjunction with the Department of iii Scientific and Industrial Research, changes in the pollution of the atmosphere which will be recorded over the next few years should be of exceptional interest, and improvement in the condition of the atmosphere could well be a major exercise in preventive medicine Supervision of Food and Food Hygiene The section of the Report dealing with this subject lists the considerable number of complaints in regard to the condition of food on purchase which were brought to the notice of the Department. The nature of the complaints, as seen in the Peport, is very varied and every case is carefully examined and fully gone into. The majority of the complaints have some justification for their being brought to the Department and it will be apparent from the legal proceedings recorded in the same section that statutory enforcement of the provisions of the Food and Drugs Act is sometimes necessary. Apart from enquiry into complaints received from members of the public, the Inspector staff concerned carry out a considerable number of visits to food premises. Co-operation with food traders in voluntarily improving methods of food storage and food hygiene is, of course, always to be preferred In the long run, food traders will conform to the standards of hygiene which the public demand. While complaints, of a trivial nature are not welcomed, it is regarded as a desirable feature in the interests of the public that a substantial proportion of housewives should be aware that if they are sold foodstuffs of any nature which appear to be doubtful, they may obtain an expert opinion at the Public Health Department. It will also be noted in the summary of legal proceedings that there were a number of successful prosecutions in respect of unsatisfactory food premises. Finally in this connection, it should be pointed out that it is only possible for this essential public health work to be carried out if properly qualified and experienced Public Health Inspectors are available. Staff shortages have created difficulties in this work as in other fields and it is not possible to avoid considerations of salary attractions to avoid reductions in the services which the public naturally and rightly expect. Health city The Islington Home Safety Committee, and a summary of its work during the year are dealt with in the Report and particular mention can be made of the nepartment's publication of the handbook, "Sense About Safety " , which includes some of the talks given to the Home Safety Committee. Attention was also given to other health education work, including food hygiene and atmospheric pollution. Elderly Persons Although the Council's statutory functions in respect of elderly persons are relatively limited, nevertheless a considerable volume of work is being done. Elderly persons are brought to the notice of the Department because of some social, housing health or sanitary problem which is being encountered and. for which there is no routine solution on a personal level. There are now approximately 3,000 elderly persons on the Department's register who for various reasons, have been visited and are being kept under observation to a greater or lesser extent. Some details of the various ways in which the Department's staff are able to help elderly persons are given in the Report, but mention may be made in particular of the valuable cleansing and laundry service, which enables a physically handicapped elderly person to get himself or herself personally cleansed and deals with the laundering of clothing and bed linen, the latter being cleansed and returned within twentyfour hours. The cleansing service includes personal cleansing done at home by the Department's staff where the person concerned is unable to visit the Public Baths and there is no bathroom in the house which, unfortunately, is true in most Islington houses. The Department's ambulance for the transport of persons to the Bathing Centre has also proved its value. As in previous years, the elderly persons' section in the Annual Report contains particulars of individual cases where official action had to be taken under the National Assistance Act, 1948. and a small selection only of the type of case where persuasion was successfully applied in the betterment of circumstances in which the old person was living. Elderly persons, like all others, must be well nourished for the maintenance of good health. The "Meals-on-wheels' service performs a useful health function, and its effectiveness from a health point of view could be still further increased if it were possible to arrange for at least five meals per week instead of the present maximum of two to the recipients of the service. iv Staff and General It is with pleasure that I again express my personal thanks for the work done during the year to Dr J P.J Burns Deputy Medical Officer of Health and to the principal representatives of the public health team in their respective sections - Mr W. C Bartlett Chief Public Health Inspector Mr. H. Plinston, Deputy Chief Public Health Inspector and Mr E.J Sharp Chief Clerk The fact that the preventive health services in Islington are administered by two separate Authorities - the Borough Council in respect of the environmental health services and the London County Council in respect of the personal health services has necessitated liaison between the respective health departments carried out in the most co-operative spirit if the greatest benefits to the public are to be obtained This situation has continued over the years and it is with pleasure therefore that I express personal thanks to Dr Wilfred G Harding, Divisional Medical Officer Health Division 3 and his staff for the happy manner in which this liaison has been carried out in practice. I am pleased also to record again my appreciation to the two principal Committees concerned with the work of the Public Health Department and their respective Chairmen during the year namely Alderman A J Rogers of the Public Health Committee, and Councillor E J Bayliss of the Housing Committee for their support and consideration of the many matters and reports I have been privileged to place before them V. FREEMAN Medical Officer of Health 1 MEMBERS OF THE PUBLIC HEALTH COMMITTEE (As at 31st December 1961) MAYOR: Alderman LAWRENCE R. WEBSTER, J.P. ALDERMEN: MRS. CLARA MARGARET COLEBECK HERBERT JAMES LOWTON LYGOE, M. B. E. , J.P., M.S.M., L. C. C. ALBERT JOHN ROGERS CounciIlors: GEORGE ARTHUR WILLIAM AINSWORTH MRS. ZARA BAGNARI WILLIAM DRADEY EDWARD CHARLES BADEN FORD ALBERT GEORGE LANGDON HYDE MRS. MARY EVA GERTRUDE HYDE HENRY JAMES REID TERENCE CORNELIUS ROONEY LEWIS ROSS MRS. MARGARET MARY SHORT MRS EMILY MARY SIMMS WALTER SMITH MRS. BRONWEN STRADLING VIVIAN STEWART STRADLING Chairman: Alderman ALBERT JOHN ROGERS Vice- Chairman: Councillor MRS. EMILY MARY SIMMS STAFF OF THE PUBLIC HEALTH DEPARTMENT, TOWN HALL, ISLINGTON, N.1. Medical Officer of Health: V. FREEMAN, M. R. C. S. , L. R. C. P. , D.P.H. Deputy Medical Offi-cer of Health: J.P.J. BURNS, M.C., M.B., B. Cta. , B.A.O., D.P.H., (Part-time) Public Analyst: D. F.H. Button, A. R. C. S., F. R. I.C. Chief Public Health Inspector: W.C. Bartlett, M.A.P.H.I., M.R.S.H. (b)(c)(d) Deputy Chief Public Health Inspector: H. Plinston, (b)(c) Supervisory Public Health Inspector: J. S. Ashworth, (b) 2 Public Health Inspectors: H. Archibald (b)(c) A, Aslamidis (b)(c) K.L. Garner (b)(c) Miss V.M. Goddard (b)(c)(f)(g)(h) R. T. Govett (b)(c)(e) V.H. Haynes (b) H, P. Johnson (a) A. R. Kempshall (a) W. S. LeMaitre (a)(b) A. C. Lochhead (a) N. Lightowlers (b)(c)(d) S.E. Muggeridge (b)(c)(e) Miss S.H. Prentice (b)(c)(f)(g)(h) G. A. Reid (b)(c) K, E. Sewell (b)(c)(d)(e) J. E, Sisson (a) U.P. Stanton (b)(c) R.C. Whittaker (b)(c) T. Lawson (b)(e) (12 vacancies) Technical Assistants - Clean Air Act 1956: R. A. Drake J. A. Lane Chief Clerk: E.J. Sharp Clerical Staff: S. A. Bishop Mrs, M. Brain W. R. Causton* E. E Conner Mrs. V. E. Cook B. Cowell Mrs. J.M. Crisp Miss M.L. Doherty Mrs. 0. Easson J.P. Green P. Hardwick Miss M.E Hudson L. Hummerstone D. Jefferys Mrs. E. Johnson W. A. McAdam Mrs. C. A. McCausland Mrs. S. R. Moody C.J. Moore D. A. Owen P. L. Regan Mrs. V. D. Skinner Mrs. S. A. Street J. Thompson S. Wright* Old People's Health Officer: Mrs, I.D. Milbank (g)(h) Infectious Diseases Visitor: Mrs. C. M Burton (h) Treatment Centre, Seven Sisters Road, N.7. W. G. Jollie (Engineer-in-Charge) 4 Home Visitors 4 Bathing Attendants 1 Stoker Handyman X Handyman 2 Drivers Mrs. H.W. Godkin (Nurse-in-Charge) (h) 1 Assistant Driver 1 Ambulance Driver 2 Disinfectors (1 vacancy) Rodent Control: C. Jackson (Rodent Officer'; 3 Rodent Investigators 6 Rodent Operators (a) - Certificate of the Public Health Inspectors' Education Board (b) - Certificate of the Royal Sanitary Institute and the Sanitary Inspectors' Examination Joint Board, or other qualification as a Public Health Inspector approved by the Minister of Health. (c) - Certificate of the Royal Society of Health, or the Royal Sanitary Institute (or other approved Qualification) in Meat and Other Pood inspection. (d) - Certificate of the Royal Society of Health or the Royal Sanitary Institute in Sanitary Science. (e) - Certificate of the Royal Society of Health or the Royal Sanitary Institute in Smoke Inspection. (f) - Health Visitors' Certificate. (g) - State Certified Midwife. (h) - State Registered Nurse. 3 SECTION A GENERAL AND VITAL STATISTICS Area of the Borough 3, 092 acres Population Registrar-General's estimate of civilian population Mid-year 1961: 227, 170 Live Births BIRTH RATE PER 1,000 ESTIMATED RESIDENT POPULATION Totals M. F. Unadjusted Islington Area Comparability Factor Adjusted England & Wales Legitimate 4, 674 2, 405 2, 269 Illegitimate 738 390 348 5, 412 2, 795 2,617 23.8 0.91 21.7 17.4 Illegitimate live births per cent of total live births 13.6 Still Births RATE PER 1,000 TOTAL (LIVE AND STILL) BIRTHS Totals M. F. Islington England & Wales Legitimate 79 50 29 Illegitimate 13 7 6 92 57 35 16.7 19. 1 Total live and Still Births 5, 504 Notifications of Births For the year ended 31st December, 1961. 5, 394 (corrected figure from L. C.C.) Marriages (Provisional figures Marriages solemnised in the Borough the year 2, 404 4 Deaths Infant mortality (deaths under 1 year; Total deaths 115 RATE PER 1,000 LIVE BIRTHS Islington England & Wales 21.2 21.6 Legitimate 19.7 Illegitimate 31. 2 Neonatal mortality rate (deaths under 4 weeks) 15.5 Early neonatal mortality rate (deaths under 1 week) 14. 2 Perinatal mortality rate PER 1,000 TOTAL LIVE AND STILL BIRTHS (still births and deaths under 1 week combined) 30.7 Maternal deaths (including abortion) Total deaths 7 RATE PER 1,000 LIVE AND STILL BIRTHS 1.27 0.34 All deaths RATE PER 1,000 POPULATION Total M. F. Islington England & Wales Unadjusted Area Comparability Factor Adjusted 2,590 1,337 1,253 11.4 0.97 11.1 12.0 CLASSIFICATION OF DEATHS WITH AGE DISTRIBUTION (REGISTRAR GENERAL S RETURNS) CAUSE OF DEATH AGE GROUPS All Ages 0- 1- 5- 15- 25- 45- 65- 75- M. F. To t a1 M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. 1. Tuberculosis, Respiratory 15 7 22 - - - - - - - - 1 3 9 2 3 - 2 2 1. 2. Tuberculosis, Other 1 - 1 - - - - - - - - - - - - - - 1 - 2. 3. Syphilitic diseases 5 4 9 - - - - - - - - - - 2 1 2 1 1 2 3. 4. -Diphtheria - 2 2 - - - - - 1 - 1 - - _ _ - _ - - 4. 5. Whooping Cough - - - - - - - - - - - - - - - - - - - 5. 6. Meningococcal Infection - 1 1 - 1 - - - - - - - - - - - - - - 6. 7. Acute Poliomyelitis - - - - - - - - - - - - - - - - - - - 7. 8. Measles - - - - - - - - - - - - - - - - - - - 8. 9. Other infective and parasitic diseases 1 3 4 - - - - - 1 - - - - - 1 - - 1 1 9. 10. Malignant neoplasm, stomach 36 22 58 - - - - - - - - 1 - 13 5 11 8 11 9 10. 11. Malignant neoplasm, lung bronchus 141 29 170 - - - - - - - - 5 1 79 11 40 9 17 8 11. 12. Malignant noeplasm, breast - 45 45 - - - - - - - - - 5 - 17 - 9 - 14 12. 13. Malignant neoplasm, uterus - 20 20 - - - - - - - - - 2 - 9 - 6 - 3 13. 14. Other malignant neoplasms 119 101 220 - - - 1 - - 2 1 4 8 40 28 43 31 30 32 14. 15. A-and-Leukamia 7 8 15 - - 1 - 1 - - - 3 - 2 5 - 1 - 2 15. 16. Diabetes 5 13 18 - - - - - - - - - 1 2 3 2 5 1 4 16. 17. Vascular lesions of the nervous system 92 164 256 - - - - - - - - 2 1 24 21 31 44 35 98 17. 18. Coronary disease, Angina 241 162 403 - - - - - - - - 14 - 103 17 60 58 64 87 18. 19. Hypertension with heart disease 21 18 39 - - - - - - - - 1 - 4 2 4 2 12 14 19. 20. Other heart disease 80 144 224 1 - - - - - 1 - 3 2 19 21 18 28 38 93 20. 21. Other circulatory disease 59 105 164 - - - - - - - - 4 - 16 7 17 20 22 78 21. 22. Influenza 7 8 15 - - - - - - 1 - 1 - 1 - 3 2 1 6 22. 23. Pneumonia 82 116 198 7 8 - - - - - - 1 2 11 10 19 16 44 80 23. 24. Bronchitis 168 85 253 1 - - 2 - - 1 - 1 - 45 7 46 23 74 53 24. 25. Other disease of the respiratory system 17 14 31 - - - - - - - 1 2 - 8 7 5 2 2 4 25. 26. Ulcer of stomach and duodenum 19 10 29 - - - - - - - - - - 6 1 8 5 5 4 26. 27. Gastritis, enteritis, diarrhoea 5 9 14 2 3 2 - - - - - - - - 1 - 3 1 2 27. 28. Nepthritis and Nephrosis 8 1 9 - - - - - - - - - - 6 1 1 - - - 28. 29. Hyperplasia of prostate 15 _ 15 - - - - - - - - - - 1 - 4 - 10 - 29. 30. Pregnancy, Childbirth and Abortion - 7 7 - - - - - - - 1 - 6 - - - - - - 30. 31. Congenital Malformations 10 14 24 2 11 1 1 2 - - - - 1 3 - 1 - 1 1 31 32. Other defined and ill-defined diseases 97 107 204 51 26 - - - - 3 1 6 3 15 15 9 25 13 37 32. 33. Motor vehicle accidents 22 7 29 1 - - 1 - - 4 1 4 - 4 1 5 - 4 4 33. 34. All other accidents 45 15 60 - 1 3 - 3 - 4 - 7 - 14 1 7 1 7 12 34 35. Suicide 16 11 27 - - - - - - 1 - 5 5 5 3 3 2 2 1 35. 36. Homicide 3 1 4 - - 1 - 1 - 1 - - 1 - - - - - - 36. All Causes 1, 337 1,253 2,590 65 50 8 5 7 2 19 6 65 41 432 197 342 301 399 651 Totals 2,590 115 13 9 25 106 629 643 1,050 Percentages 100 4.44 0 50 0. 35 0.97 4.09 24.29 24.82 40.54 COMPARATIVE VITAL STATISTICS - 1948 TO 1961 (Compiled from Registrar General's Returns) 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 Population 227,170 222,940 223, 400 225,800 227,800 228, 300 228,800 230,500 233,500 235,300 235,800 238,200 239,580 238,200 Live Births - (Total 5,412 5,195 4,972 4,592 4,582 4,322 3,945 4, 063 3,969 3,897 3,880 4,091 4, 389 4,608 (Illegitimate) 738 652 557 494 467 402 340 336 296 282 285 302 318 331 Birth Rate per 1,000 population (Unadjusted) 23.8 23.3 22.3 20.3 20.1 18.9 17.2 17.6 17.0 16.56 16.45 17.17 18.32 19.34 Still Birth Rate per 1,000 births. 16.7 198 19.52 21.94 19.68 21.51 21.09 19.31 22.66 17.89 20.94 17.48 19.87 18.94 Deaths 2.590 2,466 2,580 2,594 2,457 2,566 2,591 2,425 2,669 2,876 3,131 2,760 2,958 2,682 Death rate - (Unadjusted) 11.4 11.1 11.55 11.49 10.19 11.24 11.32 10.52 11.43 12.22 13.28 11.59 12.35 11.26 Maternal Death rate per 1,000 births 1.27 0.19 1.18 1.28 0.64 0.45 0.25 0.48 0.99 1.01 0.50 0.72 0.67 0.85 Death rate of Infants under 1 year 21.2 21 22 23 21 21 26 17 24 22 28 29 27 35 Marriage rate per 1,000 population 21.17 21.24 21.51 21.0 20.73 21.44 20.95 19.35 19.08 17.85 19.17 18.37 18.61 19.67 T. B. Notifications per 1,000 population (all forms) 1.46 1.83 1.67 2.13 1.51 1.81 1.97 1.94 2.08 2.03 1.77 2.05 2.20 2.25 Death-rates per 1,000 population - Pulmonary T. B. 0.10 0.05 0.10 0.14 0.12 0.15 0.20 0.16 0.16 0.30 0.30 0.38 0.52 0.66 Neoplasm of Lung, Bronchus & Trachea. 0.75 0.82 0.71 0.68 0.67 0.62 0.52 0.53 0.57 0.54 0.54 0.54 * * Suicides 0.12 0.13 0.14 0.15 0.11 0.15 0.13 0.13 0.14 0.076 0.15 0.09 0.12 0.15 Motor Vehicle Accidents 0.13 0.15 0.13 0.13 0.092 0.13 0.14 0.082 0.071 0.076 0.11 0.10 0.06 0.08 Other violent causes 0.26 0.26 0.25 0.18 0.23 0.22 0.22 0.17 0.20 0.22 0.26 0.26 0.25 0.43 * Not separately recorded. SUMMARY OF INFANT MORTALITY 1961 (Based on Registrar General's Returns) Primary Cause of Death Under 1 day Days Weeks Months 1961 (1960) 1 - 2 2 - 3 3-4 4 - 5 5 - 6 6 - 7 1 - 2 2-3 3 - 4 1 - 2 2-3 3-4 4 -_5 5 - 6 6 - 7 7-8 8-9 9 - 10 10-11 11 - 12 Totals Totals Measles Whooping Cough - Meningococcal Infection 1 1 (1) Tuberculosis - Lungs Tuberculosis - Other form. Bronchitis 1 1 (1) Pneumoaia 1 1 2 1 4 1 2. 2 1 15 (19) Influenza Enteritis and Diarrhoea 1 1 1 1 1 5 (1) Premature Birth 11 3 3 1 18 (37) Congenital Malformation, Birth Injury, Ateleetasis, Atrophy and Marasmus 27 8 4 2 1 1 1 1 3 1 2 1 1 1 1 55 (43) Syphilis Suffocation Overlying Violent Causes 1 1 (2) Road Traffic Accidents 1 1 All other causes 6 1 4 2 1 1 1 1 1 18 (5) TOTALS 44 12 12 5 2 1 1 1 4 1 5 3 5 3 4 3 2 3 1 3 115 (109) 8 COMMENTS ON VITAL STATISTICS Births The increases in recent years in the births and birth-rates continued in 1961. For the first time the birth-rate (23 8 per thousand population) exceeded that of the peak year of the post-war • 'bulge" , 1947, when the rate was 23.55. It seems likely that the increase will continue and, as I commented in my Annual Report last year, those concerned with the future planning of health services, housing, schools, and general services should take this population trend into account. 13 6 per cent, of all 1961 births were classified as illegitimate. This rate also continues to rise and the social significance of the increase, together with the population groups most affected, would repay further study Population The mid-year estimated population, 227, 170, shows a considerable increase over the 1960 figure. Whilst due mainly to the decennial adjustment in calculation based upon the 1961 Census, nevertheless this rise reverses the trend, since 1951, of a steady fall in population, The Preliminary Report of the 1961 Census has been received and the following statistics have been extracted:- Acreage Population Intercensal Change 1951 1961 Numbers Per Cent. London 74, 898 Males 1,565,873 1,522,380 Administrative Females 1,782,083 1,672,734 County Total 3,347,956 3,195,114 152,842 4.6 Islington 3,092 Males 111,201 111,613 Metropolitan Borough Females 124,431 117,220 Total 235,632 228,8 33 6,799 2.9 It should be noted in connection with the above Census figures that the Registrar General's estimate of population for mid-year, 1960 was 222,940, and since the Registrar General has made an annual allowance for a decrease of population from 1951 onwards, it will be apparent that the Census population is substantially more than was estimated. It will be noted also that the intercensal decrease of 2.9 per cent,,, for Islington,was substantially less than the corresponding percentage of 4.6 for the whole of the County of London, The decrease in the population has not been uniform The Census gave intercensal increases in population for the following boroughs:- Hampstead; Kensington, Stoke Newington and Wandsworth, and the majority of London Boroughs have, therefore, lost population to a greater extent than 4.6 per cent., in the years 1951/1961. Another point of interest from the Census return is that the number of males was 412 more in 1961 than in 1951, as against a reduction in the number of females by 7,231 This feature would appear to be peculiar to Islington since the County of London figures show a reduction of males in the intercensal period, although the reduction of females was more than twice as great Further Census details will be published in due course and will, no doubt, provide valuable information on population changes since 1951 which, in this Borough, have been quite considerable. 9 The following table (extracted from the Registrar General' s Returns) gives the estimated number of children under the age of 15 years in the County of London and in Islington. Under 1 year 1 - 4 Total under 5 5-14 Total under 15 London Admin. County 57,600 190,200 247,800 395,800 643,600 Islington 5,280 15,720 21,000 28,400 49,400 Deaths The death-rate was somewhat higher this year than in I960, there being a greater number of deaths from the respiratory causes of influenza, pneumonia and bronchitis, as compared with last year, when a lower than average incidence was reported. The following table is reproduced for the current year showing the seasonal influences affecting deaths due to respiratory causes. Under 1 year 1-54 55 - 64 65 - 74 75 + Total January 3 5 9 22 30 69 February 1 4 14 26 62 107 March 2 6 5 15 31 59 April - - 4 6 13 23 May 2 5 3 4 18 32 June 2 1 3 9 17 32 July 1 1 3 1 2 8 August - 1 2 4 8 15 September - 2 6 2 12 22 October 3 2 3 5 14 27 November - 1 6 4 24 35 December 2 4 9 17 35 67 Deaths of infants under one year The infant mortality rate, at 21 per thousand live births, is the same as last year 38 per cent, of all infant deaths occurred within the first 24 hours following birth and 67 per cent, within seven days of birth. Prom one to twelve months the greatest risk to infants is due to respiratory disease, particularly pneumonia Of a total of 32'deaths in this age group, 13 were due to pneumonia. Maternal Mortality The extremely low maternal mortality reported last year was, unfortunately, not maintained in 1961, when there were 7 maternal deaths. The particulars of these deaths are as under, and it will be noted that five of them were consequent upon abortion: - Age Cause of death 32 Pyaemia and general peritonitis and pyometrium in consequence of recent abortion. Not fully or further disclosed (Open Verdict), 41 Renal failure due to infected abortion due to self-instrumentation of uterus. Self-induced miscarriage 21 Infected abortion Not fully or further disclosed. 10 Age Cause of death 37 Meningitis (Friedlander). Associated with infected abortion. (Open Verdict). 32 Afibrinogenaemia following upon full term parturition. 37 Infected abortion (C1. Welchii) due to injection of fluid into genital passages. Self-induced abortion. 38 Haemorrhage from placenta praevia (28 weeks pregnancy). Respiratory Tuberculosis The accelerated downward trend in deaths due to tuberculosis of the lungs noted in my previous annual report, was not continued this year, when the rate rose from .05 per thousand population to 0.10 per thousand, which was the same as 1959. However, the rate is still a comparatively low one and should be considered in conjunction with a slight fall in new cases for this year, which is commented upon elsewhere in this report. Malignant Growths of Lung and Bronchus The number of deaths in males from this cause was less than in 1960 as shown in the table. This is the first occasion since 1955 when there has been a break in the regular year-by-year increase in the deaths in men caused by malignant disease of the lungs. Whether a peak has been reached, or whether the 1061 figures are only a fortuitous tei rorarj brep.lc and nothing more, only future returns can show. In contrast with the change in male deaths, it has unfortunately also to be recorded that the number of female deaths due to the same cause in 1961 was the highest yet, although the total female deaths is still only a relatively small proportion tf the total male deaths due to lung cancer. With regard to the ages at which death occurs, it is still a fact that approximately 60 per cent, of the male deaths from lung cancer have occurred below the age of 65 years. Deaths Male Female Total 1950 115 14 129 1951 104 23 127 1952 107 20 127 1953 114 19 133 1954 98 25 123 1955 103 17 120 1956 119 22 141 1957 127 25 152 1958 130 24 154 1959 145 26 171 1960 156 26 182 1961 141 29 170 The following information has been kindly furnished by Dr. Brett, Medical Director, Static X-Ray Unit, Drayton Park, in respect of persons passing through the Unit and found to have primary lung cancer tumour. The figures given include residents outside the Borough as well as Islington residents. Male Female Number of cases found 65 12 Bate per 1,000 examined over the age of 35 years 9.8 2.0 11 Coronary Disease with Angina Attention has been drawn in recent years, both in this country and in some countries abroad - notably in the United States, to the increase in deaths due to coronary disease of the heart with angina and its possibility of causing sudden death in men in late middle life. Islington deaths due to this cause, both in men and women have been analysed and a summary of the mortality of the past ten years is given below. It will be seen that from 1959 onwards there have been quite substantial increases in males in the age group 45/65, and to a lesser extent in the 65/75 age group. The same increase has not occurred below the age of 45 or above the age of 75, There has also been some increase in deaths due to this cause in women but this seems to have affected almost entirely women over the age of 65. Ages 25 - 45 - 65 - 75 - Total M F M F M F M F M F 1952 5 - 79 18 69 40 66 72 219 130 1953 15 2 62 16 76 56 52 70 205 144 1954 8 - 57 13 54 51 59 66 178 130 1955 9 1 78 20 70 47 52 79 209 147 1956 4 2 72 23 62 51 80 75 218 151 1957 10 2 78 25 50 49 70 95 208 171 1958 7 1 71 21 68 74 66 88 212 184 1959 9 - 97 22 74 62 57 89 237 173 1960 13 - 106 27 91 47 66 89 276 163 1961 14 - 103 17 60 58 64 87 241 162 Totals 94 8 803 202 674 535 632 810 2203 1555 Accidents The following table gives the deaths from accidents to Islington residents from 1952 onwards:- 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 Motor vehicle accidents 18 18 19 33 29 21 30 30 34 29 Other violent accidents 48 46 40 50 51 52 40 55 57 60 In the following table causes of accidental deaths in 1961 are analysed, in their respective age groups. Type 0- 1- 5- 15- 25- 45- 65- 75+ M. F. Total Motor Vehicle Accidents 1 1 - 5 4 5 5 8 22 7 29 Fails - - - - 3 6 5 12 16 8 26 Accidental Poisoning (Solid, Liquid Gases and Vapours) - - - - 2 5 1 3 9 2 11 Drowing - - 2 2 - 1 - - 5 - 5 Fire - 3 - - - - - 3 3 3 6 Inhalation of Stomach contents, ingestion of food, etc - - - . - - - - • - - Other (Railway Accidents,etc.) 1 - 1 2 2 3 2 1 10 2 12 Total 2 4 3 9 11 20 13 27 67 22 89 Fatalities due to motor vehicle accidents were lower than in 1960. Other fatal accidents were increased by 3. 12 SECTION B PREVALENCE AND CONTROL OF INFECTIOUS AND OTHER DISEASES Notifiable Infectious Diseases and Deaths during the year 1961 Disease Number of Notifications Number of Deaths Removed to Hospital Number of Cases returned to RegistrarGeneral after correction of Diagnosis Cases "coming to knowledge" but not Notified Smallpox (1) - - - - Scarlet Fever 156 (128) 1 16 152 15 Diphtheria 10 (4) 2 9 4 - Enteric Fever (including Paratyphoid) 2 (6) . 2 2 Typhus Fever (-) - - - - Puerperal Pyrexia 247 (160) - 236 247 - Ac. Primary & Influenzal Pneumonia 44 (56) 1 13 44 1 Ophthalmia Neonatorum 37 (17) - 35 37 - Acute Encephalitis 6 (2) - 6 4 - Meningococcal Infection. 6 (4) 1 6 7 1 Anthrax. - (-) - - - - Dysentery 263 (804) - 43 250 71 Malaria (1) - - - - Erysipelas 18 (15) - 6 8 1 Measles 3310 (1436) - 84 3306 207 Whooping Cough 69 ( 565) - 10 67 8 Ac. Poliomyelitis 4 (27) - 4 1 - Food Poisoning. . 119 (131) - 17 112 22 Tuberculosis - Lungs 309 ( 370) 22 - 238 - Tuberculosis - Other Forms. 23 (39) 1 - 23 - Scabies 58 ( 62) - 1 58 116 (Figures in brackets are notifications for 1960) Domiciliary Visiting of Infectious Disease Cases and Contacts - No. of Visits Smallpox 97 Measles 3,178 Scarlet Fever 165 Whooping Cough. 75 Diphtheria 203 Acute Poliomyelitis 21 Enteric Fever (including Typhoid and Paratyphoid) 19 Food Poisoning 116 Meningococcal Infection 4 Scabies 127 Dysentery 427 Vermin 139 Malaria 1 Infective Hepatitis 184 Acute Encephalitis. 9 Ineffective Visits 860 Erysipelas 19 Others 35 Total 5,679 13 Smallpox The year 1961 was marked by a larger number of references for suspected smallpox and supervision of possible smallpox contacts than had occurred for many previous years. The reasons for this were in part due to the changed situation caused by the far greater speed of air travel as compared with surface travel which enables persons travelling through parts of the world, particularly Asia, where smallpox is still relatively common and endemic, to arrive in this country well within the incubation period. Before air travel became so common any traveller from the Middle East incubating an infection would in all probability have begun to show symptoms while still on board ship and in consequence illness would be reported to the Port Health Authorities on arrival in this country. On the other hand, with air travel, illness may not appear until some time after the person has arrived in this country although apparently well on arrival. Visitors to this country who have developed skin rashes have sought advice by attending at a doctor's surgery or at the Casualty Department of a hospital and it will be understood that in these circumstances there may be many administrative and medical complications when there is even the possibility of a diagnosis of smallpox. During the year, nine patients were referred by family practitioners to the Medical Officer of Health or his Deputy as suffering from rashes of a type where it was desirable to exclude smallpox as a possible cause. Seven of these were confirmed as cases of chickenpox,. one was an allergic rash, and the remaining case was diagnosed as not smallpox One of those reported as a suspect was a male Nigerian Doctor on holiday in Islington from Northern Ireland. He presented himself at an Islington hospital because he was unwell and had a rash. The Deputy Medical Officer of Health and, later, a Smallpox Consultant, were called in and the patient was transferred to an isolation hospital. All appropriate precautions were taken and the resultant diagnosis was chickenpox, Another suspect, a man,' aged 35 years, arrived at the casualty department of a local hospital with symptoms of cough, cold, headache, for three days and he had since developed a rash. The Medical Officer of Health was informed and all admissions to the hospital were temporarily suspended. The Deputy Medical Officer of Health visited the hospital on the same evening and was of opinion that it was not a case of smallpox, The hospital was therefore re-opened. Twentysix of the hospital medical and nursing staff were vaccinated by the Deputy as a precautionary measure. A Consultant" s report was also received on a case where the family practitioner reported a rash of uncertain origin. The subsequent diagnosis was ''sensitivity reaction". Information was received during early April that a ship had arrived in London with a history that a member of the crew had been landed at Suez in late March suffering from modified smallpox. All passengers and crew had been vaccinated since that date. Pour members of the crew and one passenger resided in Islington; they were visited by staff of this Department and kept under surveillance for the incubation period, A young man who arrived in England in early September by ship (Ostend-Dover) was admitted to Long Reach Hospital, Dartford, suspected to be suffering from smallpox. The diagnosis was not confirmed and all laboratory tests proved negative. A family practitioner reported that a patient of his, who resided in Islington, had been in contact with this suspected case This young man was visited by this Department and revaccination advised. He was kept under observation until notification was received from the Ministry of Health that the original suspected case was not confirmed. Smallpox was diagnosed in a Pakistani visitor, who arrived at London Airport on 25th December, from Karachi. He was seen at University College Hospital, and removed to Long Reach Hospital, Dartford, where he died. This man had been staying in another borough, but eight contacts or possible contacts were resident in Islington and kept under observation for the routine quarantine period; all were vaccinated. 14 Numerous enquiries appertaining to this outbreak were dealt with in the Department, and of course, the matter extended into early January, 1962. The taxi in which the patient was conveyed to hospital was garaged in Islington and had to be taken out of commission and disinfected as soon as it was known that a smallpox patient had travelled in it. A request received from a Postal Sorting Office in the Borough, for disinfection of mailbags and parcels arriving from Pakistan was carefully considered in conjunction with Ministry of Health and Treasury Medical Officers. The Ministry was of opinion that possible risk of transmission of infection by such means was infinitesimal. The question of vaccination of postal sorters was also raised and the General Post Office finally issued a directive for all Sorting Offices on these matters. The public were naturally concerned by smallpox reports and the local press were most helpful in maintaining liaison with the Public Health Department of the Borough Council as well as with that of the London County Council, and in giving a balanced and authoritative presentation of the facts. Many enquiries were received in regard to vaccination and there was a greatly increased demand upon practitioners for this service. The possibility of general or mass vaccination was raised, but the Ministry of Health did not consider it necessary at this stage. The Ministry's view was that the present procedure of intensive tracing of all possible contacts and suspects, together with immediate vaccination or revaccination of such persons should be sufficient, as in the past, to contain any possible spread. Only if such measures failed would the Ministry recommend mass vaccination for consideration. Nevertheless, in view of the great public demand, the London County Council, through its Divisional Health Office, temporarily increased the vaccination sessions available to the public so that the demand for protection could be adequately met. The following is the table of successful vaccinations performed over the past eleven years:- 1st January - 3rd July, 1948 1,124 5th July - 31st December, 19 702 1949 1,628 1950 2,307 1951 3,291 1952 2,450 1953 3,055 1954 4,052* 1955 5,942* 1956 2,590* # 1957 3,624* 1958 3,449* 1959 2,692* 1960 2.753* 1961 3,782* (Figures kindly furnished by Divisional Medical Officer,London County Council) * Including Re-vaccinations # Group Sessions for Schoolchildren discontinued The Vaccination Acts were rescinded under the National Health Service Act, 1946, as from 5th July, 1948. 15 Certificates of Vaccination and Inoculation - Authentication - Ministry of Health Circular 60/48 Applications for authentication to be dealt with by the Medical Officer of Health numbered 730 as against 802 for the previous year. The applications comprise requests for authentication of International Certificates of Vaccination and Inoculation against smallpox, cholera, typhoid, etc., and constitute a substantial item of work. The certificates, of course, are required for travel abroad. Measles and Whooping Cough Measles and Whooping Cough became generally notifiable in London at the end of 1939, Prior to this there was only a limited notification. 16 Measles The number of measles cases notified in 1961, 3,310, is the highest recorded in the Borough for any one year. A sharp increase in the measles notifications began in October, 1960, and reached a peak in February, 1961, with nearly 900 notifications in this month alone. It will be seen from the chart below that this measles outbreak was sustained at a high level between October, 1960, and June, 1961, and Islington, in common with the rest of London - and, in fact, the country - suffered the most extensive measles outbreak experienced so far. The great majority of cases were relatively mild and uncomplicated but approximately 80 were referred to hospital. Fortunately, in spite of the large number of measles cases there was no instance in which measles led to a fatal issue. The following table shows the age-groups of the notified cases during 1961:- Under 1-5 5 years and 1 year upwards No. of Notifications in 1961 163 1,931 1,216 Percentage of total Notifications 4.9 58. 3 36.8 No. of Deaths 17 Whooping Cough Comments were made in my Annual Reports for 1958 and 1959 on the unusually low incidence of whooping cough. 1960, with 565 notifications, showed a substantial increase, but 1961, with 69 notifications, has shown the lowest number of notifications of whooping cough on record. The age groups are as follows:- Under 1 year 1 - 5 5 years and upwards No. of Notifications in 1961 11 38 20 Percentage of total notifications 15.9 55.1 29.0 No. of Deaths _ _ - The following chart shows the measles and whooping cough position since 1949. 18 Fatality Rates per 1,000 notifications each age group (1952-1961) Percentage of notifications (1952-1961) Under 1 1 - 5 5 & upwards Under 1 1 - 5 5 & upwards Measles1.13 . 08 0.11 4.0 55.9 40.1 Whooping Cough. 4.52 1.17 - 13.5 52.4 34.1 Whooping Cough Prophylaxis Whooping cough immunisation is carried out in the Local Health Authority Clinics and by general practitioners. The Divisional Medical Officer has kindly made available the following information in regard to Islington children:- Whooping cough Prophylaxis Total attendances 15,920 Completed cases 4, 801 )Primaries 1, 517) Boosts London (Measles and Whooping Cough) Regulations. 1938 Home visiting of measles and whooping cough cases was carried out by the Home Visitors as under:- No. of Investigations Measles Whooping Cough No. of Ineffective Visits Re-visits 3,173 73 412 7 Acute Poliomyelitis There was only one confirmed case of poliomyelitis in 1961. This, of course, not only maintains the downward trend referred to in last year's Annual Report but is the lowest figure recorded since 1946. No. Reported No. CONFIRMED 1961 13 1 1960 34 15 1959 1958 109 37 60# 10 1957 55 25 1956 34 13* 1955 97 56 1954 35 12 1953 47 17 1952 30 15 1951 21 8 1950 54 31 # Includes a case notified posthumously and not included in Registrar-General's Tables. * Two cases, with onset in December, 1956, were notified in 1957, and are included in the above returns. 19 Onset dates Jan. Feb. Mar. Apr. May June July Aug. Sept. Oct. Nov. Dec. 1961 - - - - - - 1 - - - - - 1960 - - - - - - 2 3 5 1 4 - 1959 - - 1 3 23 18 10 1 1 2 1 - 1958 - - - 1 1 • 2 - . 5 1 - 1957 2 - - 2 1 2 5 4 5 2 2 - 1956 1 - 1 1 1 - - - - 2 3 4 1955 2 1 - - - 1 5 11 15 9 9 3 1954 - - - - - - 1 3 2 3 2 1 1953 1 - - - 2 2 6 2 3 1 . . 1952 - - - - 1 - 2 8 - 2 1 1 1951 1 - - 1 1 2 - 2 1 - - - 1950 1 - 1 - 2 2 10 10 1 2 2 - Age distribution: Under 1 year 1 - 5 - 15 - 25 and over 1961 - 1 - - - 1960 2 10 2 - 1 1959 2 27 24 2 5 1958 1 4 4 - 1 1957 1 6 12 2 4 *1956 - 4 5 2 2 1955 5 19 15 5 12 1954 - 7 2 1 2 1953 - 6 5 3 3 1952 - 1 5 4 5 1951 - 2 2 2 2 1950 1 11 12 4 3 Deaths: 1961 Nil 1960 Nil 1959 6 (l¾ years; 6 years; 2 of 11 years; 24 years; 28 years; 22 years - the latter contracted outside the borough and not included in the above tables). 1958 Nil 1957 1 (7 years) 1956 Nil 1955 3 (17½ years; 30 years; and 5 years - the latter contracted outside the borough and not included in the above tables). 1954 1 (27 years) 1953 3 (4 years; 15 years; 24 years) 1952 Nil 1951 Nil 1950 2 (6 years; 12 years). The onset of the disease of the 6 year old was in 1949 * Two cases, with onset in December, 1956, were notified in 1957, and are included in the above returns. Protection against Poliomyelitis Protection against poliomyelitis is given at all Welfare Centres in Islington under arrangements made by the L.C.C. "Open Sessions'' are held and attendance at these is not restricted by place of residence, hence it is not possible to give the number of Islington residents who have attended. The following figures show the numbers of persons who have been protected at sessions in 1961 in the whole of the Division comprising the areas of the Boroughs of Finsbury, Holborn and Islington. 20 Age groups Second injections given Third injections given 0 - 4 4,879 3,221 5-18 2,256 2,270 19-28 2,709 2,795 Others 3,955 6,706 Totals 13,799 14,992 In June, 1961 fourth injections were commenced for schoolchildren aged 5-12 and up to the end of the year a total of 9,589 of these injections were given. Diphtheria Cases and Deaths 1937 - 1961 Year Notified Cases Deaths Year Notified Cases Confirmed Cases Deaths Year Notified Cases Confirmed Cases Deaths 1927 720 25 1939 254 Not available 10 1951 43 17 1 1928 760 25 1940 101 2 1952 23 - - 1929 1008 34 1941 174 11 1953 12 1 - 1930 1248 42 1942 201 2 1954 6 1 - 1931 714 15 1943 188 9 1955 9 1 - 1932 601 20 1944 94 38 2 1956 8 2 - 1933 551 33 1945 86 45 3 1957 9 1 - 1934 815 32 1946 137 50 - 1958 6 2 - 1935 760 13 1947 72 19 1 1959 48 9 - 1936 583 31 1948 44 7 - 1960 4 - - 1937 623 20 1949 55 17 2 1961 10 4 2 1938 595 23 1950 50 19 1 Corrected Notifications Year England and Wales London Islington 1944 23,199 758 38 1945 18,596 801 45 1946 11,986 747 50 1947 5,609 451 19 1948 3,575 335 7 1949 1,881 221 17 1950 962 81 19 1951 699 30 17 1952 101 5 - 1953 267 13 1 1954 176 8 1 1955 169 17 1 1956 63 11 2 1957 40 4 1 1958 79 38 2 1959 103 75 9 1960 53 18 - 1961 52 28 4 21 The four cases reported above, two of which were fatal, occurred early in the year and were part of a diphtheria outbreak involving a London County Council Training Centre situated in the Royal Borough of Kensington. Notification of a case of diphtheria was received in February in respect of an eleven-year-old girl attending this Centre. Further enquiries were instituted in conjunction with the Medical Officer of Health, Kensington and the Divisional Medical Officer of Health Division 3. There were 26 Islington children attending this Centre. Families of these children were visited, swabs taken, their immunisation history was ascertained and letters were sent to their medical practitioners. Absentees from the Centre resident in this Borough were followed up and there was close liaison with the practitioners concerned. Of the four Islington cases, three were attenders at the Centre and the fourth case was a sister of one of the fatal cases. In addition, two carriers were discovered, one being a boy attending the Centre and the other his sister. Although this outbreak was fortunately limited, precautionary measures were taken to deal with any possible spread and arrangements were made for immunising material to be kept at the Town Hall during some week-ends for use by medical practitioners should the occasion arise. The precautionary measures necessitated intensive work by the Department for a limited period and 145 visits were made to homes of cases and contacts and 315 swabs were taken. Throughout this incident there was very close co-operation with the Divisional Medical Officer and the Divisional Health Office in connection with the interchange of information and the visiting of school absentees and domiciliary contacts by the Borough Council's staff. There was also close liaison with the Divisional Medical Officer and the Medical Officer of Health, County Hall, in regard to the issue of information bulletins for the press, including announcements made in the local press. The Ministry of Health were kept informed of the situation in the Borough and the measures taken. The ages and immunisation states of the cases are shown in the following table:-" Diphtheria Cases and Immunisation state 1947 • 1961 (Inclusive) Year IMMUNISED NON-IMMUNISED Deaths Age Groups Age Groups Unknown Total 0 - 5 5 - 15 15+ 0 - 5 5 - 15 15+ 1961 - - 1 - 2 - 1 4 15 yrs. - imm. in infancy 6 yrs.- unknown 1960 - - - - - - - - - 1959 - 6 - - 3 - - 9 Nil 1958 - 1 • - - - 1 2 Nil 1957 - 1 - - - - - 1 Nil 1956 - - 1 - - 1 - 2 Nil 1955 - - - - - = 1 1 Nil 1954 - - - - - - 1 1 Nil 1953 - - - - - 1 - 1 Nil 1952 - - - - - - - - - 1951 1 2 - 8 5 1 - 17 7 yrs. - not imm. 1950 - 5 - 3 7 4 - 19 7 yrs. - not imm. 1949 1 3 - 2 8 3 - 17 4 yrs\ . . 6 yrs/* not lmm- 1948 1 2 1 1 - 2 - 7 Nil 1947 - 5 1 2 4 5 2 19 16 yrs.- not imm. 3 25 4 16 29 17 6 100 7 deaths (one immunised) 32 62 22 Diphtheria Immunisation, 1961 Dr. Wilfrid G. Harding, Divisional Medical Officer, London County Council, has kindly supplied the following figures in respect of Islington for the current year. As immunity tends to wane with the passage of time, the Immunity Index relates only to children who have been inoculated during the last 5 years by general practitioners, and in L.C.C. Welfare Centres and Schools. This is consonant with the Immunity Index given by the Ministry of Health. Age at 31. 12.61 i.e. born in year Under 1 1961 1-4 1960 - 57 Last complete course (whether primary or boost) 1957-61. 1,948 12,190 Mid-year population 5,280 15,720 Immunity Index 36.9 77.5 Food Poisoning Number of notifications received 1947 7 1948 10 1949 55 1950 104 1951 148 1952 58 1953 243 1954 104 1955 294 1956 141 1957 150 1958 183 1959 164 1960 131 1961 119 In accordance with Circular 2/50 of the Ministry of Health, the following table summarises the outbreaks of food poisoning and the character of each outbreak. Date No. of Notifications No. of persons served No. of cases reported No. of deaths Foods involved and Organisms responsible 1. 23. 7. 61 1 55 12 including 2 symptomless carriers) 2 (known non-Islingtori residents) Uncertain Food: Salmonella Typhi Murium 23 Information was received at the end of July that a resident in the Borough of Horrisey was in Whittington Hospital as a confirmed case of salmonella typhi murium food poisoning. He attended a wedding breakfast and buffet which was held at an address in Bethnal Green Approximately 55 guests had been present and on enquiry, following investigation of 17 of the guests who lived in Islington, including the bride and groom, it was ascertained that 10 of them had been ill with symptoms which included headache, abdominal pains, vomiting and diarrhoea. The illness lasted between 1 and 7 days, with an average of 2 to 3 days, and was moderate to severe in character. Specimens were examined from all the Islington guests and salmonella typhi murium was isolated from 9 of these. A further guest reported as having been ill, who lived in the Borough of Wandsworth,was referred to the Medical Officer of Health concerned and this case was also found to be positive. The Medical Officer of Health, Bethnal Green, was kept informed from the outset and subsequently reported that none of the guests living in his area had shown any symptoms of food poisoning. A large variety of foods had been consumed including sausage rolls, veal and ham pie, brisket of beef and chipolata sausages, but it was not possible to isolate any particular item as having caused the outbreak. The outbreak was reported to the Ministry of Health as required by their Memo, 188/Med. 1958, although incomplete as to conditions of storage, preparation, etc. of food in Bethnal Green. Typhoid and Paratyphoid Fever Information was received in respect of a male adult who was transferred to an isolation hospital as a suspected typhoid fever case and the diagnosis was subsequently confirmed, The patient was of Cypriot origin and employed as a cook in another London borough. Several of the family and domiciliary contacts of this case were also engaged in food handling and the Medical Officers of Health of the Boroughs concerned were kept fully informed. No definite source of infection was discovered and fortunately bacteriological investigations of all contacts proved negative. A seven-year old boy was admitted to hospital with suspected typhoid fever, paratyphoid B infection was subsequently diagnosed, but the possible source of this infection could not be ascertained. Dysentery The incidence of dysentery in 1961, with 334 cases was considerably lower than in 1960 when there were 1,029 cases. From the detailed analysis, it will be noted that 153 cases (46%) were under 5 years and 101 cases (30%) of school age. This distribution was due to the fact that the main outbreaks occurred in 4 Day Nurseries, (2 outside the Borough) and in 2 Islington Schools. Cases in the under 5 year age group related also to an Islington Residential Institution. These were cases transferred from a similar Institution, where dysentery had occurred, in another Borough. to DYSENTERY IN TSLINGTON - 1961 Month 1961 No. of Cases Sex Notified Coming to knowledge Confirmed Cases AGE GROUPS Case employed as a food handler Food Handler Contacts Water Closet Acconmodation 0- 1- 5- 15- 25- 45- 65 + Same family Separate family Separate Shared January 6 M 4 1 1 1 1 - F 2 - 4 1 1 - - - - - - - - 2 4 February g M 5 1 2 1 1 1 1 _ F 3 - 6 - - 1 2 - - - - - - 3 6 March 89 M 40 5 - 12 22 3 7 1 F 38 6 66 - 11 23 1 7 - 2 1 10 6 32 57 April 24 M 11 1 3 4 2 - 3 - - F 8 4 15 - 1 3 - 4 1 3 1 3 1 10 14 May 28 M 13 4 1 6 3 - 7 - - F 7 4 15 1 6 - 1 2 1 - 1 3 1 2 26 June 42 M 11 6 - 10 5 - 1 1 - F 15 10 32 1 12 5 - 4 1 2 4 23 4 14 28 July 12 M 5 - 4 - 1 _ - F 7 - 3 1 2 1 1 2 - - - 3 3 3 9 August 33 M 14 2 3 10 3 - - - - F 15 2 24 3 8 2 2 1 1 - 1 1 2 1 32 September 9 M 6 0 3 1 1 1 - - F 3 - 4 - - - 2 - - 1 - 1 - 3 6 October 43 M 19 5 1 15 8 - - - - F 13 6 34 - 5 10 - 3 1 - 1 3 - 30 13 November 17 M 5 2 - 2 4 - 1 - F 8 2 9 - 5 2 - - 1 2 - 6 - 3 14 December 22 M 4 4 17 - 7 1 - - - «- 3 2 9 1 3 F 7 7 2 8 3 - - 1 TOTAL 334 M 137 30 229 19 134 101 13 46 10 11 9 56 19 112 222 F 126 41 TUBERCULOSIS 1961 PRIMARY NOTIFICATIONS OF PULMONARY CASES 25 Tuberculosis The number of deaths due to tuberculosis of the lungs, whilst still comparatively low was higher than the previous year when I reported on the number of deaths being the lowest ever recorded With new cases, however, there was a slight fall of some 78% The distribution of cases as in former years, differs between the sexes. In adult males the new cases, as will be seen from the table, are spread fairly evenly throughout the age groups, In females, on the other hand, the greatest proportion of new cases is in adolescents and young women under the age of 35, accounting for over 50% of all new cases of tuberculosis in females at all ages. New Cases and Mortality during 1961 NEW CASES DEATHS Ages Respi ratory Non-Respi ratory Respi ratory Non-Respi ratory M. F M. F M. F. M F. O 2 - - - - _ _ 1 4 4 1 - - — - - 5 10 6 1 1 - - - - 15 19 28 - 7 - - - - 25 25 19 2 1 - 1 - - 35 24 14 1 - 1 2 - 45 32 9 2 4 2 1 - - 55 22 7 - 2 7 1 - - 65 and upwards 20 5 1 1 5 2 1 - Total for all ages 158 92 8 16 , 15 7 1 * J V 274 V 23 Hates per 1,000 population: New cases: pulmonary 1.10 non-pulmonary 0.11 Deaths : pulmonary 0.10 non-pulmonary 0.004 Public Health (Tuberculosis) Regulations, 1952. Although information in regard to the coming and going of tuberculous patients under these Regulations is not as completers it was under the Tuberculosis Regulations 1930, every effort is made to confirm the correctness of the Register still maintained in the Department. The total number of cases on the Register of the Department as at 31st December, 1961 was: - Pulmonary Males 1,509 Females 1,168 Non-Pulmonary Males 131 Females 170 2,978 26 The corresponding figures for previous years are:- 1960 3,034 1959 3, 074 1958 3, 172 1957 3, 108 1956 3r 048 1955 2, 945 1954 2,922 1953 2, 802 1952 2,575 1951 2. 404 1950 2, 368 1949 2, 490 Islington Chest Clinic, Whittington Hospital St. Pancras Chest Clinic, Margaret Street. St. Marylebone Mass X-Ray Unit of the North-West Metropolitan Regional Hospital Board,32, Drayton Park N. 5. The Borough is well and conveniently served by the above centres to which patients may be referred, or where persons may attend for examination. Cases on Chest Clinic Registers Pulmonary Non-Pulmonary Total Adults Children Adults Children Adults Qii ldren M. F. M. F. M. F. M. F. M. F. M. F. Number of definite cases of tuberculosis on Chest Clinic Register as at 31st December 1961: Islington C.C. 1,162 825 44 50 49 79 6 12 1,211 904 50 62 St. Pancras C. C. 117 7-8 7 11 5 4 - 1 122 82 7 12 1,279 903 51 61 54 83 6 13 1,333 986 57 74 Grand Total 2,450 The corresponding figures for previous years are:- I960 2, 497 1959 2, 564 1958 2, 735 1957 2,818 1956 2, 772 19 55 2,751 1954 2, 851 1953 2,738 1952 2, 575 1951 2, 443 1950 2, 238 1949 2, 127 The Islington X-Ray Centre Dr. G.Z. Brett, Physician on Charge of the Mass X-Ray Unit sited at Drayton Park, has kindly agreed to the following inclusion from his report which reviews the work of the Unit over the past ten years. 27 The Centre was officially opened in February 1952. It was originally intended to provide X-ray facilities for all those living and working in the Borough of Islington Within a year, however, not only Doctors practising in Islington but also practitioners from the neighbouring boroughs of St, Pancras, Hornsey, Stoke Newington, Shoreditch, Hackney and Hampstead were making use of the facilities of the Centre. In the course of the years, doctors' referrals increased in number until their percentage attendance of the total rose from 19% in 1952 to 50% in 196L The figures in the table below give an analysis of the results obtained during the last decade. (This includes Islington referrals but covers a much larger area). Total Doctors' Referrals % No. X-rayed 300,713 118, 657 40,0 Active Pulmonary Tuberculosis 1,734 1, 191 68.0 Rate per 1, 000 5,7 10.0 - Cancer of the lung 632 569 90.0 Rate per 1, 000 2. 1 4.8 - The high discovery rate of active Pulmonary Tuberculosis, 50% of which proved to be sputum positive, illustrates the epidemiological value of what has been achieved. The fact that doctors' referrals yielded 68% of active Tuberculosis, while forming only 40% of those X-rayed, points to the importance of radiological examination of persons from this source. The total number of cases discovered decreased slowly over the years, but is still too high for complacency: (166 in 1961). The figures for lung cancer show a high incidence in the area served by the X-ray centre, particularly among doctors' referrals, who produced 90% of the cases. Although the resection rate was only about 20%, it seems that the earlier an X-ray is taken in men over 40 with chest symptoms, the greater the chance of operability of the growth. The value of the X-ray facilities at Drayton Park can be measured not only by the detection of serious lung disease, but also by the frequent finding of transient acute inflammatory conditions of the lungs; during the past decade 1, 510 pneumonias were diagnosed, quite often in patients with only upper respiratory or influenza-like symptoms. In addition to these positive findings, it is hoped that the thousands of negative reports have also assisted the General Practitioner in his daily clinical work. 1961 Male Female Total No of persons X-rayed 6,041 5,964 12, 005 No. of cases 44 37 81 Rate per 1, 000 7.3 6. 2 6.7 Tuberculosis Care Committee The London County Council is responsible for care and after care work under Section 28 of the National Health Service Act, 1946, but the Islington Tuberculosis Care Committee remains in being, working in conjunction with the Islington Chest Clinic, and Members of the Borough Council and the Medical Officer of Health serve on this Committee. The Tuberculosis Care Committee is able to assist patients in many ways, and the Tuberculosis Care Organiser reports that an average of 89 cases per quarter were helped with extra nourishment during the year, while Joans of beds, bedding and medical appliances were made to 2 (two) patients from the L.C.C. loan stock, others were referred to various organisations for assistance. 28 The Care Committee administers an occupational therapy service with occupational therapists employed by the L.C.C. The following figures show the service being provided in a typical week: No. of sessions of instructions in homes during a week 10 No. of patients receiving instruction at home 29 Scabies and Vermin As will be seen from the following table, there are still a considerable number of cases of scabies, or itch, and also vermin infestation. It is realised that the attainment of a good standard of personal cleanliness and hygiene is not a straightforward matter in the majority of Islington homes which have no bath, separate washing facilities for each household, or hot water points. This means that more effort must be made by families living in homes where washing facilities are inadequate by modern standards, but nevertheless, the situation is gradually improving even if more slowly than could be wished. Scabies Vermin Children under 5 years - Number treated ,27 26 Number of baths given 62 Number of treatments - 26 L.C.C. Children Number treated 49 148 Number of baths given 107 Number of treatments - 153 Adults Number treated 91 51 'Number of baths given 188 Number of treatments - 57 * In addition 6 Special Baths were given. Home Visiting Follow-up home visiting for cases of scabies and vermin was carried out by the Home Visitors of the Treatment Centre as under:- Families Visited Revisits Ineffective Visits Total Scabies 77 10 84 171 Vermin 100 3 98 201 Anthrax Information was received from the Northern Polytechnic that Microbiology students, whilst taking practice slides from various parts of the kitchens, isolated what was thought were some anthrax spores from an old chopping block. The block was burned but the slides were retained. The College was visited by a Public Health Inspector (Pood), and the slides were sent to the Public Health Laboratory for examination, but no colonies of B. anthracis were found. The students are to be complimented on their alertness in appreciating the possible significance of their findings. 29 Bacteriological Examinations All specimens for bacteriological examination dealt with through the Department are submitted to the Public Health Laboratory Service, County Hall, S.E.I, Examinations carried out Total Swabs (Diphtheria) 792 Sputum (Tuberculosis) 19 Faeces & Urine (Enteric Fever) 180 Blood (Enteric Fever) - Faeces (Food Poisoning) 361 Food (Food poisoning) - Faeces (Dysentery) 2,379 Faeces (Poliomyelitis) 11 Swabs (Streptococci) 135 Swabs (Pertussis) - Swabs (Influenza) - Smears (Variola) 4 Scrapings (Variola) - Other Specimens 60 TOTAL 3,941 (I am indebted to Dr. Wilfrid G. Harding, Divisional Medical Officer, London County Council, for the 1961 figures in connection with vaccination, diphtheria and whooping cough inoculations, and chest clinics). 30 SECTION C SANITARY CIRCUMSTANCES OF THE AREA (In conjunction with Mr W,C, Bartlett, Chief Public Health Inspector). The shortage of Inspectors continued throughout the year Difficulty is still being experienced in recruiting and retaining Public Health Inspectors in certain parts of the Metropolitan area, as a result of which at the close of the year under review in Islington, the number of Inspectors engaged was three less than the previous year As mentioned in the foreword of this report, the Public Health Inspectors'Education Board revised the syllabus and conditions of training during the year, and it is hoped that as a result more will be attracted to take up this career As far as possible the Inspectors coped with the situation, but the fact that no systematic inspection of the District is able to be carried out, is a matter of regret. As mentioned in my previous report the question of multiple occupation of houses caused concern, and in order to obtain any approximation of the size of the problem a survey of certain areas is very necessary With the present staff available, this is not possible, Such properties require constant attention, and a weekly visit is certainly not too frequent in certain instances. The power of local authorities to control such properties has been strengthened by the Housing Act 1961, which came into force in November this year This statute enables inter alia the Minister of Housing and Local Government to make Regulations for governing multiple occupied houses, and it is anticipated that such Regulations will be made in 1962, Reference has been made in earlier reports concerning nuisances which arise from time to time by the deposit of putrescible and other refuse on vacant land Permanent improvement has not been possible due to the further tipping or refuse, soon after the site has been cleared The Public quite rightly complain, but great difficulty is experienced in obtaining the co operation of complainants who could give supporting evidence,concerning unauthorised tipping in court. It is hoped, however, that conditions will improve for the London County Council (General Powers) Act 1961, which came into force during the year, enables the Borough Council subject to certain conditions, to enter any derelict, neglected or unsightly land, which is detrimental to the amenities of the locality, and carry out such works, and do such other things as may be expedient for the purpose of restoring or improving, and thereafter preserving the appearance of the land The Factories Act 1961, which was passed during the year, repeals the 1937 Statute It is a consolidating Act, and will come into operation in April. 1962. The Licensing Act, 1961, except as otherwise provided, came into force in November Licensing Justices may refuse applications for the grant or renewal of licences for restaurants or guest houses on certain grounds, including the fact that the premises in question are not suitable and convenient for the use contemplated, having regard to their character and condition. The Council has power to inspect, and an application may be refused by the Justices, if the local authority has been unable to carry out such inspection. In addition power is given to the Council to object to an application for the issue or renewal of a Registration Certificate for any Club premises on certain grounds including the unsuitability of the premises concerned This part of the Act comes into force on 1st March 1962 The Heating Appliances (Fireguards) Act.1952 and the Oil Burners (Standards) Act,1960, are replaced by the Consumer Protection Act.1961. The Home Secretary may by regulation impose requirements concerning prescribed goods, and their components, in order to prevent or reduce death or personal injury from their use, This Statute came into operation in August. Any regulation made under the previous Acts are still in force. It became necessary to keep a close watch on second-hand shops selling heating appliances. Unguarded fires offered for sale were withdrawn upon a visit by the Public Health Inspector It appears that such fires are often sold by auction to second hand dealers, who do not realise that they are committing an offence when offering a fire for resale It is interesting to note that one complaint was 31 received in respect of the sale of an electric fire which was alleged to contravene the requirements of the Fireguards Act. Upon investigation it was found that the purchaser himself had interfered with the heating element. The heating appliance as sold satisfied the prescribed tests. The Department assisted with publicity during the National Fire Prevention Week. The Council is empowered to serve Notice requiring the repair or renewal of drains and water closets under Sections 40 and 109, of the Public Health (London) Act, 1936, and to serve Notice under Section 25 of the London County Council (General Powers) Act, 1955, requiring the abatement of nuisances of so urgent a character that the normal nuisance procedure would cause unnecessary delay. In default the Council may carry out the work, and recover the costs involved. It has been the practice in the past for the Borough Engineer to be responsible to provide an estimate of the cost of carrying out the work and to arrange when necessary for the work to be executed, either hy the Council's Contractors or by one of the builders on an approved panel. Due to the amount of work involved the Borough Engineer found that his Department was unable to continue supplying particulars, and in the circumstances the Council transferred these functions to the Public Health Committee. The Borough Engineer will still be responsible for the preparation of estimates for drainage work required where such work is below ground. The number of immigrants residing in the Borough is increasing. Families from abroad arriving in this country may find it difficult to accommodate themselves to their new surroundings, and problems may arise that can only be resolved by mutual patience and goodwill. In order to promote a better understanding between the races the London Council of Social Service held a meeting of Local Authority representatives. The Chief Public Health Inspector attended on this occasion. Two Inspectors attended a week-end school held by the Association of Public Health Inspectors at Ashford in April this year. Summary of Work done by District Public Health Inspectors (i) Inspections Houses/flats inspected under Public Health (London) Act, 1936 4, 294 Separate lettings 10, 418 Rati sit*Houoes/flafes 10,641 Separate lettiags 24, 399 (ii)Other inspections and visits Miscellaneous 3,157 Prevention of Damage by Pests Act, 1949 40 Infectious Diseases 207 National Assistance Actsy1948 and 1951 (Aged & Infirm) 21 Factories Act, 1937 - Outworkers 175 Shops Act, 1950 2,752 London County Council (G.P. ) Act 1954 - Hairdressers and Barbers 266 Pet Animals Act, 1951 59 Heating Appliances (Fireguards) Act, 1952 . Consumer Protection Act, 1961, and Regulations 31 Noise Nuisances 42 Food Premises 264 Non-effective visits 3,369 32 (iii) Nuisances and Notices Notices served - Public Health (London) Act, 1936. (a) Intimation 2,308 (b) Statutory 1,467 Notices complied with - Public Health (London) Act, 1936 (a) Intimation 1,470 (b) Statutory 692 Nuisances foun 5,545 Nuisances abated 6,451 Number of houses improved 2,354 Separate lettings in above 2,622 Total number of improvemen 6,324 (iv) Legal Proceedings 50 Abatement Orders made by Magistrate 15 Abatement Order amended 1 Abatement Orders complied with 24 Further Proceedings for disobedience of Abatement Orders - (v) Drainage Plans examined 31J Examinations an 287 (vi) Complaints Outstanding (at end of 1960) 271 Received during the year 3,710 plus 391 repeated complaints Dealt with during year 3,736 Outstanding (at end of 1961) 245 (vii)Land Charges Act, 1925 Enquiries received 3,179 Properties involved 4,497 Investigations 4,497 (viii)Rent Act, 1957 Applications for Certificates of Disrepair (1) Number of applications for certificates during 1961 24 Number of applications brought forward from 1960 2 Number of applications carried forward to 1962 0 Total number of applications receiving attention 1961 26 (2) Number of decisions not to issue certificates 12 Number of Undertakings on Form 'K' accepted 8 (3) Number of decisions to issue certificates 10 (a) in respect of some but not all defects 9 (b) in respect of all defects 1 (4) Number of Undertakings given by landlords under paragraph 5 of the FirstSchedule 8 (5) Number of Undertakings refused by Local Authority under proviso to paragraph 5 of the First Schedule Nil (6) Number of certificates issued where undertakings not accepted Nil 33 Applications for Cancellation of Certificates (7) Applications by landlords to Local Authority for cancellation of certificates 47 Number of applications brought forward from 1960 3 Number of applications carried forward to 1962 2 Total number of applications receiving attention 1961 50 (8) Objections by tenants to cancellation of certificates 15 (9) Decisions by Local Authority to cancel in spite of tenant's objection 6 (10) Certificates cancelled by Local Authority 34 Applications by Overseas Companies for Certificates of Repair Applications received Nil Certificates issued Nil (ix) Improvements effected as a result of Service of Notices under the Public Health (London) Act, 1936 1. Brickwork - walls repaired or rebuilt 64 2. Drains cleared, repaired, etc 416 3. Dampness remedied 1,157 4. Fireplaces and ranges repaired/renewed 73 5. Floors repaired 282 6. Flues repaired 35 7. Internal walls repaired 454 8. Ceilings repaired 512 9. Rainwater pipes/gutters repaired/renewed 355 10. Roofs repaired 698 11. Rooms cleansed 64 12. Sinks provided/renewed 37 13. Soil pipes repaired and renewed; 60 14. Staircase or passages cleansed 8 15. Staircases repaired 71 16. Waste pipes repaired/renewed 172 17. Water Closet Apartments cleansed 8 18. Water Closet Pans and Traps renewed 96 19. Water Closets - flushing apparatus repaired or renewe 114 20. Water Closets - general 204 21. Water supplies provided 11 22. Water service pipes repaired 67 23. Window sash cords renewed 592 24. Windows repaired or renewed 380 25. Miscellaneous improvements 394 Total 6,324 Public Health (London) Act, 1936-Sections 40 and 109 London County Council (General Powers) Act, 1953, Sections 25, 26 and 27. Work required to be done for Drains, Sanitary-Conveniences and Premises. (a) Consequent upon Notices served by the Public Health Inspectors, the Council, in pursuance of their powers under the above Acts carried out works in default to a total cost of £2,631 9s. 4d. during the period under review. 34 This amount is apportioned as follows under the respective Acts and Sections:- Public Health (London) Act, 1936, Section 40 £ s. d. 1,456 11 4 Public Health (London) Act, 1936, Section 109 61 10 5 London County Council (General Powers) Act, 1955, Section 25 382 18 0 London County Council (General Powers) Act, 1955, Section 26 - - - London County Council (General Powers) Act, 1955, Section 27 730 9 7 £2,631 9 4 Legal Proceedings Public Health (London) Act, 1936 Failure to comply with Statutory Notices contrary to Section 82 Date Address Magistrate's Decision (1) 3. 1. 61 136 Copenhagen Street Ordered to abate within 7 days. (2) 3. 1. 61 136 Copenhagen Street Ordered to abate within 7 days. (3) 7. 2. 61 21 Jackson Road Absolute discharge. Defendant to pay £1. 5s. Od. costs. (4) 7. 2. 61 79 Benwell Road Ordered to abate within 21 days. Defendant to pay £2 2s. Od. costs. (5) 11. 4. 61 42 Benwell Road Fined £3. Ordered to abate within 21 days. Defendant to pay £1 9s. 6d. costs. (6) 11. 4. 61 8 Stanmore Street Ordered to abate within 21 days. Defendant to pay £1. 9s. 6d. costs. (7) 2. 5. 61 87 Mildmay Road Fined 10s. Od. Defendant to pay £1. Is, Od. costs. (8) 2. 5. 61 90 Pembroke Street Case adjourned sine die (9) 2. 5. 61 165 Widdenham Road Ordered to abate within 21 days. Defendant to pay £1. 9s. 6d. costs. (10) 6. 6. 61 18 Westbourne Road Summons withdrawn (11) 6. 6. 61 181 Offord Road Summons withdrawn (12) 6. 6. 61 181 Offord Road Fined £2. Ordered to abate within 21 days. Defendant to pay £1. 9s. 6d. costs. (13) 6. 6. 61 113 Holloway Road Case adjourned sine die (14) 6. 6. 61 136 Copenhagen Street Fined £25. 0s. Od. Abatement order amended to different name. Defendant to pay £1 Is. Od. costs. (15) 4. 7. 61 25 Parkfield Street Fined £2. Defendant to pay £1. Is. Od. costs. (16) 4. 7. 61 5 Hargrave Park Fined £5. Ordered to abate within 14 days. Defendant to pay £2. 9s. 6d. costs. 35 Date Address trate's Decision (17) 18. 7. 61 379 Holloway Road Fined 12. Ordered to abate within 7 days. Defendant to pay £2. 10s. 6d. costs (concerned abatement of noise nuisance). (18) 25. 7. 61 65 Carleton Road Fined £2. Ordered to abate within 28 days. Defendant to pay £1. 9s. 6d. costs. (19) 5. 9. 61 22 Courtney Road Fined £1. 0s. Od. Ordered to abate within 21 days. Defendant to pay £1. 9s. 6d. costs. (20) 5. 9. 61 20 King Henry's Walk Fined £2. Defendant to pay £1. Is. Od. costs. (21) 5. 9. 61 400 York Way Fined £1. 0s. Od. Defendant to pay £1. Is. Od. costs. (22) 7. 11. 61 60 Colebrooke Row Fined £10. Ordered to abate within 28 days. Defendant to pay £1. 9s. 6d. costs. (23) 5. 12. 61 47 Pulteney Street Fined £5. Ordered to abate within 21 days. Defendant to pay £1. 9s. 6d. costs. (24) 5. 12. 61 15 Scholefield Road Fined £5. Ordered to abate within 21 days. Defendants to pay £1. 9s. 6d. costs. (25) 5. 12. 61 42 Dartmouth Park Hill Fined £5. Ordered to abate within 14 days. Defendant to pay £1. 9s. 6d. costs. Failure to comply with Statutory Notice contrary to Section 105 Date Address Magistrate's Decision 7. 11. 61 70 Gifford Street Justices directed owner to instal additional toilet within 60 days. An Appeal was heard at the New River Petty Sessional Court held at the Town Hall on 3rd October, 1961: The appeal was against the service by the Council of a Notice under Section 109 of the Act in respect of 40 Ecclesbourne Road. The Justices ordered that the tenant should do the work to comply with the requirements of the Notice. It was subsequently understood that the owners took over the question of repair work, and that this was proceeding. Disinfection and Disinfestation (a) General Number of rooms disinfected after cases of infectious disease 628 Number of rooms treated for vermin 1,260 Number of rooms included in the above figure treated for vermin (free of charge) 273 (The majority of free cases were carried out on behalf of elderly or infirm persons or persons of limited means) Number of families where effects were treated with D.D.T. as a precautionary measure prior to rehousing 38 The department also undertook the disinfection of wards in a number of hospitals upon request for co-operation in the control of hospital infection. In addition the routine disinfection of pillows and woollen blankets from a hospital in the Borough continued for the purpose of reducing the likelihood of infection, particularly of staphylococcal infection. 36 2, 440 bags containing blankets and pillows were disinfected in accordance with an agreed procedure. Eight visits were paid by the Public Health Inspector to a factory to supervise the treatment of 50 bales of stockings or other material for export. The total weight of bales treated was 16 tons 0 cwt„, 3 qtrs. 9 lbs. The cleansing of articles in rooms occupied by elderly or infirm persons often creates a problem The conditions are such that volunteers are sought from the Disin fecting Station staff, who undertake the appropriate cleansing after normal working hours (b) Steam Disinfection 2, 267 articles of clothing or bedding were steam disinfected (c) Fly and Other Infestations Anti-fly treatment at Ashburton Grove Depot commenced on 15th May and continued during the summer months. Disinfestation staff dealt with 6 cases where complaints of wasps3 nests had been received, The Council's Housing Estates continued to be treated for red clover mite in order to keep the infestation to a minimum Thanks are due to Dr Parkin and his staff of the Department of Scientific and Industrial Research for the very practical interest and advice afforded this Depart ment during the year, which has resulted in keeping the infestations at the various estates to a minimum. (d) Static Water Tanks Air Raid Shelters Bomb Damaged Sites, etc. Vacant sites in the borough are being re-developed where possible but there are still some sites in respect of which complaints continue to be received. The tippim of refuse and the accumulation of water in static water tanks still present a probli By arrangement with the Council's Cleansing Superintendent putrescible matter was removed by his Department upon request from the Public Health Inspector The co-operation of the London Fire Brigade in pumping out stagnant water is appreciated Warning notices are displayed under the War Damage Sites Act,1949, drawing the attention of the public to the fact that the depositing of refuse is an offence. Visits to bomb damaged sites 266 Visits to air-raid shelters and static water tanks 57 Inspections of derelict buildings 78 Atmospheric Pollution Clean Air Act 1956 Consequent upon the considerable experience which has been gained of the operation of the provisions of the Clean Air Act relating to Smoke Control Areas, the Minister of Housing and Local Government in circular 1/61, states that he does not consider that there is any longer a general need for proposals to be referred to him before Smoke Control Areas are formally submitted for his approval. It will, of course, still be necessary for local authorities to consult the Regional Advisory Committees, about supplies of smokeless fuels This simplified procedure will facilitate the making of future Smoke Control Areas THE BOROUGH OF ISLINGTON STREET MAP "Scale SMOKE CONTROL AREAS Revised phased programme North Islington Canonbury King's Cross 1959/60 No. 1 No. 1 Orders confirmed: Operative date 1st September, 1960. 1960/61 No. 2 No. 2 Orders confirmed: Operative date 1st January, 1962. 1961/62 Nos. 3 & 4 No. 3 No. 3 orders confirmed: Operative date 1st September, 1962. 1962/63 Nos. 5 & 6 Nos. 4 & 5 1963/64 No. 7 No. 6 No. 1 1964/65 Nos. 8 & 9 No. 7 1965/66 Nos. 10 & 11 No. 8 39 In circular 28/61, the Minister reminds local authorities of the need of drawing the attention of householders in smoke control areas, to the importance of installing firebars sufficiently widely spaced to enable Coke to be burned satisfactorily. In appropriate cases the replacement of firebars, with ones more suitable for coke burning can rank for grant Now that electrical ignition has been developed, the Minister in circular 31/61 states that the necessary incidental works which originally included the provision of gas ignition to open fireplaces, and extensions of gas piping or electric cable, may now include a reference to electrical means of igniting coke and other smokeless fuels Reasonable freedom of choice between gas and electrical ignition should be given to owners or occupiers, pro vided that in any particular case the total cost of the alternatives is broadly comparable. The Minister drew attention in circular 42/61, to the fact that the provisions of the Section 2 of the Clean Air Act, which provides a defence against prosecution under Section 1 where dark smoke has been emitted from the chimney of any industrial furnace will expire 5th Julyy 1963 Those concerned have been reminded that time is beginning to run out In order that the Department and in particular the Inspectors concerned with the duties under the Clean Air Act may be kept fully supplied with up to date information the Council during the year agreed to take advantage of the Clean Air Information Service of the College of Fuel Technology This has already proved advantageous to the Inspectors in the implementa tion of the Act The Council authorised the attendance of one of the Technical Assistants engaged on smoke control areas at a three day course held by the Coal Utilisation Council. This course is arranged in order that those concerned may become fully acquainted with approved appliances and the correct method of fixing same in order to comply with the statutory requirements In 1959 the Council submitted details of its provisional programme for establishing smoke control areas Since that date two Technical Assistants have been engaged to assist the inspectors responsible for duties under the Clean Air Act including work relative to smoke control areas It has therefore been found that the programme can be accelerated, and the revised programme, which again can only be regarded as provisional,is shown on the map which appears opposite page 36, The Minister in circular 12/61 drew attention to the co operative scheme for the measure ment of air pollution The essence of the scheme is the collation of measurements of air pollu tion of different kinds made by local authorities in various parts of the country and the pub lication by the Department of Scientific and Industrial Research of results in a monthly bulletin which is distributed to the participating bodies The Council is already giving assistance in this matter and in addition to the three sites which are already being used for recording atmospheric pollution, arrangements were made during the year under review with Dr. S G Burgess London County Council Scientific Adviser, in conjunction with the Warden for daily volumetric apparatus to be fitted at Hillside, St John's Way This instrument is capable of automatic 4 hour sampling during smog, and shorter period samples can be taken in exceptional circumstances by manual operation Readings commenced in July and details are made available to the Department During the year four smoke control orders were made and confirmed viz No?, 2 & 3, Canonbury and 2 & 3 North Islington All become operative next year The Council is represented on the London and Home Counties Clean Air Advisory Council by Councillor L Ross, and the Medical Officer of Health 38 Number of applications received for prior approval by local authority as to plans and specifications for new furnaces (Section 3(2)) 13 Number of applications for prior approval granted re above 13 Number of applicptions for temporary exemption as to alterations to furnaces (Section 2) Nil Number of applications for exemption granted re above Nil Inspections 1,042 Re-visits 1,098 Complaints received 46 Smoke observations 388 Contraventions found 8 Adaptations completed (domestic) 404 Notices served 20 Notices complied with 39 Prosecutions - The following is a. summary of work undertaken by Technical Assistants under the Clean Air Act, 1956. Inspections 4, 191 Re-visits and other calls 736 Non-effective visits 1,712 Miscellaneous visits 730 Recording of Atmospheric Pollution Deposit gauges and lead-peroxide candles are stationed at three, sites in the Borough results from which are recorded monthly. Volumetric apparatus is also installed at the Town Hall and the Treatment Centre, Seven Sisters Road, N. 7. The concentration of smoke and sulphur-dioxide in the atmosphere is recorded daily. The findings are forwarded to the Warren Springs Laboratory for collation and comparison with other Metropolitan Boroughs, in order that ail overall picture may be obtained for the whole of London. A summary of all recordings is set out in the following tables:- 39 Monthly Deposits recorded by the Deposit Gauges and Sulphur-Dioxide by the Lead-Peroxide Method Month Site No. Rain fall in inches (Tons per square mile) Mg. of SOg/ day collected by 100 sq. cm. of Batch. A lead Peroxide (Louvered Box) Insoluble Deposi t Soluble Deposit Total Solids January 1 2.09 11.06 4.07 15.13 4.57 9 9 2 2.29 12.09 3.91 16.00 4.28 9 9 3 2.40 8.84 6.69 15.53 2.93 February 1 2.01 11.63 8.18 19.81 3.89 * 9 2 2.21 13.05 7.42 20.47 3.59 9 9 3 2.21 9.41 7.12 16.53 2.58 March 1 0.12 12.25 3.98 16.23 3.61 9 9 2 0.12 23.35 3.71 27.06 3.60 9 9 3 0.12 11.29 3.97 15.26 2.41 April 1 1.93 15.43 6.69 22.12 2.81 » 9 2 2.05 17.32 7.02 24.34 2.81 9 9 3 2.25 15.07 6.19 21.26 1.56 May 1 0.99 9.27 1.89 11.16 0.91 9 9 2 0.99 11.33 2.61 13.94 1.49 9 9 3 0.71 7.52 2.91 10.43 0.80 June 1 1.38 8.25 4.04 12.29 1.49 9 9 2 1.58 12.06 5.13 17.19 1.50 9 9 3 1.54 6.49 5.47 11.96 1.19 July 1 1.54 6.36 2.98 9.34 0.96 9 9 2 1.50 8.18 2.98 11.16 0.97 9 9 3 0.79 13.05 3.18 16.23 0.74 August 1 1.89 5.27 4.47 9.74 1.19 9 9 2 2.40 14.21 3.11 17.32 1.22 9 9 3 2.84 9.80 4.60 14.40 0.47 September 1 2.36 8.01 7.62 15.63 2.14 9 9 2 2.48 13.31 5.63 18.94 2.12 9 9 3 2.60 8.41 3.35 11.76 0.98 October 1 2.21 3.97 9.54 13.51 2.78 t 9 2 2.56 5.96 8.78 14.74 2.69 1 t 3 2.60 6.49 7.42 13.91 1.26 November 1 2.60 3.84 8.78 12.62 3.78 9 9 2 2.88 5.63 7.42 13.05 3.56 9 9 3 2.52 3.38 6.56 9.94 1.86 December 1 2.88 11.66 7.15 18.81 4.17 9 9 2 3.07 10.20 7.15 17.35 4.19 9 » 3 2.99 9.90 ( 6.49 16.39 2.35 Hiese sites are situated at the following places in the Borough:- 1. Town Hall roof 2. York Way Court (Caledonian Road area) 3. Treatment Centre, at Seven Sisters Road. o Concentration of Smoke and Sulphur Dioxide recorded by the Volumetric Method at the two stations in the Borough Station Jan. Feb. Mar. Apl. May June July Aug. Sept. Oct. Nov. Dec. SMOKE. (Milligrams per 100 cubic metres Jan. - May) (Micrograms per cubic metre Jun. - Dec.) Public Health Office, Town Hall. Monthly average 21.0 20.0 19.0 11.0 5.0 49.0 35.0 34.0 55.0 86.0 93.0 157.0 Highest recording 56.0 31.0 42.0 20.0 22.0 80.0 60.0 70.0 170.0 298.0 353.0 796.0 Shelter House, Treatment Centre, Monthly average 32.0 28.0 20.0 10.0 5.0 40.0 42.0 29.0 60.0 91.0 118. 0 134.0 Highest recording 68.0 95.0 38.0 20.0 12.0 90.0 90.0 50.0 150.0 360.0 443.0 336.0 SULPHUR DIOXIDE (Parts per 100 million parts of air Jan.- May) (Micrograms per cubic metre June - Dec.) Public Health Office, Town Hall. Monthly average 12.8 11.5 13.0 8.0 4.2 132.0 87.5 70.0 156.9 207.9 255.5 398.1 Highest recording 24.8 21.0 32.8 18.8 11.9 329.4 150.9 183.0 429.0 489.0 598.0 802.0 Shelter House, Treatment Centre. Monthly average 15.3 11.5 12.1 6.3 4.0 99.0 74.8 78.0 138.4 195.4 210.7 408.6 Highest recording 44.3 26.6 26.0 10.5 9.4 222.0 140.4 240.2 348.9 449.0 571.0 1,042.0 41 Work of Public Health Inspectors Adnlnlsterlng Factories Act, 1937, and other legislation. Factories Act, 1937. Number of inspections 802 Number of re-visits 777 Notices served 89 Prosecutions instituted - Defects found 731 Defects remedied 736 Defects referred to H.M. Inspectors 6 Defects referred by H.M. Inspectors 7 Complaints received 76 Notices complied with 104 Public Health (London) Act, 1936. Factories visited 860 Contraventions found 193 Contraventions remedied 172 Notices served 93 Notices complied with 73 PART I OF THE ACT Prescribed Particulars on the Administration of the Factories Act, 1937. 1. Inspections for the purposes of provisions as to health (including inspections made by Public Health Inspectors.) Number of Premises Number on Register Inspections Written Notices Occupiers prosecuted (1) (2) (3) (4) (5) (i) Factories in which Sections 1,2,3, 4 and 6 are to be enforced by Local Authorities 222 119 7 - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 1,869 487 44 - (iii) Other Premises in which Section 7 is enforced by the Local Authority* (excluding outworkers' premises) 27 196 38 - TOTAL 2,118 802 89 - * i.e. Electrical Stations (Section 103 (1)), Institutions (Section 104) and sites of Building operations and Works of Engineering Construction (Sections 107 and 108). 42 2. Cases in which Defects were Pound. Particulars Number of cases in which defects were found Number of cases in which prosecutions were instituted Found Remedied Referred To H.M. Inspector By H. M, Inspector (1) (2) (3) (4) (5) (6) Want of cleanliness (S. 1) 8 8 - 1 - Overcrowding (S.2) - - - - - Unreasonable temperature (S.3) - - - - - Inadequate ventilation.IS.4) - - - - - Ineffective drainage of floors (S. 6) - - - - - Sanitary Conveniences (S.7) (a) Insufficient 46 39 - - - (b) Unsuitable or defective 677 688 - 1 - (c) Not separate for sexes - 1 - - - Other offences against the Act (not including offences relating to Outwork) - - 6 5 - TOTAL 731 736 6 7 - PART VIII OF THE ACT Outwork (Sections 110 and 111). Nature of Work SECTION 110 SECTION 111 No. of outwo rkers in August list required by Sec. 110(1)(c) No. of cases of de f au11 in sending lists to the Council No. of prosecutions for failure to supply lists No. of instances of work in unwholesome premises Notices served Prosecutions (1) (3) (4) (5) (6) (7) (6) J Making, etc. Wearing Cleaning and apparel washing 637 _ _ Furniture and upholstery 9 - - - - Umbrellas, etc 2 - - - - - Artificial flowers 112 - - - - - The making of boxes or other receptacles or parts thereof made wholly or partially of paper 111 - - - - - Brush making 11 - - - - - Stuffed Toys - - - - - - Basket making - - - - - - Carding, etc, of buttons, etc 44 - - - - - Cosaques, Christmas crackers Christmas Stockings, etc 14 _ - - - - Textile weaving - - - - - - Lampshades 18 - - - - - Feather sorting 4 - - - - - TOTAL 968 - - - - 43 Factories Act, 1937 - Section 54 Basement Bakehouses Certificates of suitability as required by Section 54 of the Factories Act, 1937, continued to be in force in respect of 9 basement bakehouses at the following addresses:- 76 Caledonian Road, N. 1. 7, Junction Road, N. 8 Danbury Street, N. 1. 59 Junctio„ Road, N 54 Archway Road, N. 146 Blackstock Road, N. 77 Newinton Green Road, N 3 Cardwell Terrace, N. 123 Newington Green Road, N. Public Health (London) Act 1936. London County Council (General Powers) Act, 1937. Noise Abatement Act, 1960 - Noise Nuisances. The complaints of alleged noise nuisances investigated during the year varied from noise arising from the playing of gramophone records to the parking of vehicles in squares. Complaints relating to noise arising from the operation of machinery were also received. It was possible during the year to secure abatement of 22 confirmed cases of noise nuisances. Action taken included a prosecution in respect of noise arising from an illseated extraction fan serving the ventilating system of a restaurant. These conditions gave rise to an acute noise nuisance in flats situated immediately adjacent to the restaurant at first floor level. Over a long period Public Health Inspectors kept observation on these particular premises, and it was only after legal proceedings that the owner took effective action. No further complaints have been received from this source, and the complainants have been most grateful for the action taken by this Department. Another complaint received was in respect of alleged nuisance from noise following dancing and bingo sessions at a hall let for this purpose during the week, and let on Sundays to a religious organisation. Observations were kept during the evenings and weekends and the matter was brought to a satisfactory conclusion. Number of Complaints received 64 Number of Inspections, etc 291 Legal Proceedings Public Health (London)Act, 1936 As amended by the London County Council (General Powers) Act, 1937. Date Address Section of Act Magistrate's Decision 18. 7. 1961 379, Holloway Road 82 Fined £2. 0s„ Od. and £2. 10s. 6d. costs. Ordered to abate nuisance within 7 days Public Health (London) Act. 1936. Section 121. Protection of Birds Act, 1954. Pigeon Nuisances The Council renewed the authority of the pigeon catcher and engaged him to give specific treatment in two areas where nuisance arose from congregation of pigeons. Several complaints were received in respect of nuisances from pigeons entering loft spaces and buildings, the Public Health Inspector was able to take necessary action to secure these premises against further entry by these birds. 44 It is interesting to note that the mechanism of a clock situated in a high building in the Borough was severely damaged by pigeons and it was necessary for the owner to carry out extensive repairs. In order to deal with pigeon nuisances effectively in residential areas, it is necessary that regular quarterly treatments be maintained. In all cases the method used by the pigeon catcher has been in accordance with those approved by the R.S.P. C. A. and the Public Health Inspector is informed when a treatment is to take place. Public Health (London) Act, 1936 (Part IV) Offensive Trades Details of the respective offensive trades in the Borough are as follows:- (a) 2 Tripe Boilers: 14/18, Market Road, Messrs. J.L. Henson [Wholesale) Ltd. 22/24, Vale Royal - Messrs. Edmund Martin Ltd. (b) 1 Knacker: 18/20, Vale Royal - Messrs. Harrison Barber & Co. Ltd. (c) 1 Fur Skin Dresser: 24, Braoey Street - Messrs. J. & A. Fischer Ltd. (d) 6 Gut Scrapers: 3, Old Slaughterhouses - Casings Ltd. 1?, Old Slaughterhouses „ Universal Casings Co. Ltd. 13, Old Slaughterhouses r Messrs. Armour & Co. Ltd. 15, Old Slaughterhouses - Messrs. Wm. Menzies Ltd. 5, Tileyard Road - Messrs. C. Edwards & Son, Ltd. Tileyard Road « Messrs. Tracey & Co. Ltd. (e) 1 Fat Me Iter: 16, Old Slaughterhouses ~ Messrs. Wn. Menzies Ltd. (f) 1 Slaughterer: 180, York Way - Messrs. Harrison Barber & Ca. Ltd. This slaughterhouse was the subject of 301 visits for the inspection of meat. (g) The Council approved the issue of a licence under Section 145 in respect of the receiving of carcasses of dead horses for human consumption at 14/16, Vale Royal - Messrs. Harrison Barber & Co. Ltd. The number of inspections, etc. of offensive trades premises were:- Inspections Re-visits Total Tripe Boilers 28 64 92 Knacker 7 27 34 Fur Skin Dresser S 5 10 Gut Scrapers 5 7 12 Fat Melter 24 41 65 Licensed Slaughterhouse 8 27 35 Diseases of Animals Act, 1935-1950 There was no action required to be taken under this legislation during the year. 45 Pbaraacy and Poisons Act 1933. During the year the Poisons List Order, 1961, and the Poisons Rules, 1961. were made by the Home Secretary. The Order added, inter alia, certain substances to the poisons lists, and the Rules imposed appropriate requirements and restrictions on the sale of special poisons. Number of listed sellers of Pa?t II poisons other than registered pharmacists 162 Number of initial registrations during the year 10 Number of visits and inspections 46 Rag Flock and other Filling Materials Act, 1951. The Rag Flock and other Pilling Materials Regulations,1951, and 1954,are superseded by Regulations made during 1961. The current Regulations prescribe (a) Used wood wool as a filling material to which the Act applies; (b) Standards of cleanliness for each kind of filling material; (c) Analysts for the purposes of tests under the Act, the fees, and the form of certificate of the results; (d) The form in which records are to be kept by occupiers of premises registered under the Act. Number of premises on register (Section 2, for Upholstery ) 50 Number of Licences issued(under Section 7 for the Storage of Rag Flock) 1 Number of inspections and visits 37 Number of samples taken 4 Number satisfactory 4 Consumer Protection Act, 1961. Heating Appliances (Fireguards) Act, 1952 Number of inspections and re-visits 31 London County Council (General Powers) Act, 1954 Hairdressers and Barbers Number of Gentlemen's Hairdressers 88 Number of Ladies' Hairdressers 92 Number of Ladies' and Gentlemen's Hairdressers 16 Number of premises where hairdressing ceased 3 Number of Establishments situated in basements 3 Number of Establishments situated in dwelling houses 1 Number of Establishments where no assistants are employed. 52 Prevention of Damage by Pests Act 1949 Complaints of rodent infestation during the year numbered about the same as last year. Details of inspection and visits, and the number of infestations found are given in the table (a) below:- Forty two infestations were traced to defective drains, and six to unsealed fittings, or dis- used drains. 46 There is no record of any ship rats in the Borough during the year under review. Quarterly inspections continued to be carried out at the Archway Group of Hospitals Three meetings of the Workable Area Committee No. 1 were held of which the Chief Public Health Inspector is Chairman. By special invitation the Chief Public Health Inspector and Rodent Officer attended one meeting of the Workable Area Committee No.3., held in the City Guildhall. With the approval of the Council, six Operators attended a one day Refresher Course given under the direction of the Minister qf Agriculture, Fisheries and Pood. Some municipal Housing Estates have caused difficulties during the year with infesta tions which, after treatment^have recurred at a later date. There were also other cases which were concluded only after much difficulty, In one instance a very heavy infestation of mice was found to be coming from under the concrete of an adjacent dust chute. Upon opening up the concrete and proofing all means of access to the dwelling the infestation was cleared. On another occasion a heavy infestation of rats was traced to a defective main drain, serving a large block of flats. The defective drain was also found to be the cause of another infestation in the grounds of a similar block of flats some distance away. This matter received the attention of the Department and the owners agreed to re-lay all defective drains serving these buildings. (a) General The following is a summary of the work carried out during the year:• Notices Served Intimations 3 Statutory Type of Property Local Authori ty Premi ses Dwelling Houses Bu s i n e s s Premises TOTAL 1. Complaints received (including repeats) 34 1,126 157 1,317 2. Number of properties inspected as a result of (a) Notification (initial complaint only) (a) 24 964 148 1,136 (b) Block Survey (b) 85 488 71 644 3. Number of properties found to be infested by rats (including Nil ship rats) 18 501 72 591 4. Number of properties found to be infested by mice 4 435 49 488 5. Re visits by Investigators 255 3,088 71 3,414 6. Non-effective visits by Investigators. - 952 38 990 7. Number of infested properties treated (new jobs commenced) 20 965 103 1,088 8. Continuation or po3t-bait treatment 40 2,696 381 3,117 9. Visits by Operators 135 10,813 654 11,602 10. Still being baited at end of year - 58 5 63 11. Completed during the year 25 1,353 127 1,505 12. Number of Business Agreements dealt with 68. 13. Members of the Rodent Staff assisted in the application of smoke machine in respect of 101 drainage tests carried out by Public Health Inspectors. NOTE:: For ttae purpose of conpletlng Sections 8, 3, 4 & 7, each property is entered once only in respect of Inspections, infestations and treatments. 47 (b) Sewer Treatments Three sewer treatments were carried out this year with the use of Fluoroacetamide (1081). As this is a direct poison no pre-baiting was necessary and no record of takes were made. Details of these treatments are as follows:- Treatment Date Manholes in Borough Poison baited 33 17.4.61 841 797 34 3.7.61 841 790 35 23.10.61 841 720 The co-operation of the Borough Engineer and his staff is appreciated. Water supplies (a) The Metropolitan Water Board is the responsible Authority for the supply of water to this Borough. The supply is satisfactory both in regard to quality and quantity. Four samples were taken from the mains supply, two for bacteriological examination and two for chemical analysis. All were reported to be satisfactory. The storage cistern in a block of flats was reported to be most unsatisfactory. Complaints that red worms were found in water drawn from this source were confirmed. The cistern in question was renewed and subsequent samples taken by the Metropolitan Water Board, who reported that the results indicated that the water was of satisfactory hygienic quality and physical appearance and up to the standard of the Board's mains. There are 46,853 dwellings in the Borough supplied directly from water mains, which serve a population of 228,833 (Census 1961). Public Health (London) Act 1936 Section 95 (1) 67 applications were received for Water Certificates and 67 Certificates were issued in respect of 404 dwellings. (2) 14 Notices were served under this section requiring the provision of water supplies to tenement houses. 11 water supplies were provided and 7 improved during the year. (b) Well Water Of the 28 bore-holes or wells known to exist in the Borough nineteen continue to be unused, being effectively sealed. Four of the remaining wells are still out of use. Seven samples were taken, three for chemical analysis and four for bacteriological examination. Whilst the results indicated that the water could not be considered free from pollution chemically the bacteriological reports were satisfactory. The water from these wells is used solely for industrial purposes. (c) Water Supplies-Miscellaneous Three samples of sub-soil water were taken. Four samples were taken of the sub-soil water at Trent Park Cemetery. 48 (d) Swimming Bath Water 68 samples were taken for bacteriological examination. All were reported to be satisfactory. By courtesy of the Chief Superintendent and Engineer of Baths and Wash-houses the following information is included in this year's report. There are six Swimming Pools at present under the control of the Council. The Swimming Bath at Hornsey Road is being reconstructed. Upon completion, which is hoped will be in 1963, there will be two Swimming Baths at this establishment. The Metropolitan Water Board supply the water for these Baths:- The method of treatment for purification is by chemical dosage: alumina ferric is the coagulant used to fulfil the function of forming a film on sand. Soda ash is the alkaline salt to counteract acidity. A pH value of between 7.4 and 7.6 has proved most satisfactory to the swimmers using these baths. Aeration is maintained by means of an air compressor. Sterilization: Chlorine gas is used a residual of 0.5 to 0.75 p. p.m. being strictly adhered to. In the summer months when heavy loads are to be expected it is kept at 0.75 p. p.m. The frequency of changing the baths water is governed by the flow through the filters which in the case of these establishments is approximately once every four hours. In the summer months when the baths are open for 12 to 14 hours daily a complete turnover of three times per day is necessary. Samples of the water at Highbury Fields open air swimming pool which is controlled by the London County Council, were also taken during the summer season for bacteriological examination. The London County Council were kept informed of the results, all of which were satisfactory and are included in the figure given at the head of this section. In addition two samples for bacteriological examination were taken from the children's paddling pool in Highbury Fields. As this is also under control of the London County Council the results were forwarded to that authority. 49 SECTION D HOUSING (In conjunction with Mr. W.C. Bartlett, Chief Public Health Inspector). The Minister of Housing and Local Government confirmed Orders under Part III, Housing Act, 1957, in relation to the under-mentioned Clearance Areas: Nos. 6, 8, 10, 12, 14, 16, 18, 20, 22, 24, 26, 28, 30 and 32 Monsell Road (14 houses). Nos. 5, 6, 7, 8, 9, 10, 11, 12, 13, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28 Camden Walk 59 and 60 Duncan Terrace, 32 Camden Passage (23 houses). In addition, the Playford Road Area comprising 44 houses was represented and declared to be a Clearance Area by the Council. In my previous report, reference was made to the problem arising from houses in multiple occupation. Many of the older type properties in the Borough are bought by owners, who let single room lettings which in many cases are occupied by persons of different nationalities, habits and customs. There is often an insufficiency of sanitary accommodation and other amenities, and action under Section 36 of the Housing Act, 1957, could result in the owner decrowding the house by a reduction in the number of families or individuals. Families evicted would therefore be in desperate need of accommodation, Not only could the owner decrowd, but tenants protected under the Rent Act would lose their protection. It was for this reason that many such properties were dealt with on an informal basis. The Housing Act, 1961, however, gives local authorities considerable new powers for dealing with bad living conditions in houses in multiple occupation. It provides for a code of management and the Minister may make regulations for the purpose of ensuring that proper standards of management are observed. In addition, where the state of the property is defective, with regard to several specified matters, a notice can be served by the local authority which in default is able to carry out the work and recover the cost incurred. It is hoped that this Statute will go a long way to remove difficulties experienced in Islington over the past few years, but there are some hundreds of these houses and progress in dealing with this urgent problem may be delayed by staffing difficulties. The Minister of Housing and Local Government confirmed Byelaws made by the Council for adequate artificial lighting on any common staircase in tenement houses and flats. These Byelaws came into operation on the 1st March this year. In three cases, authority was given for appropriate action to be taken to secure adequate lighting on the common staircase and this will be followed up to secure compliance with the Council's requirements. In view of the urgent need to provide as many homes as possible without delay, the London County Council decided to erect on certain unused sites in their ownership (the permanent development of which is unlikely to take place for a period of at least two years) temporary housing accommodation to be used to augment the County Council's general housing pool. Difficulty is often experienced in preventing property which is vacated and the subject of a Closing Order from becoming derelict and thus a Public Health nuisance. Considerable publicity was given during the year to one particular area, but in conjunction with the London County Council, the nuisance was abated. In order that investigations may be made on alleged overcrowding, it is often necessary for Inspectors to be engaged after normal working hours. In one case it was necessary for Inspectors to carry out inspections on two occasions before midnight. The number of houses and flats erected in the Borough during the year was Borough Council 88 London County Council 144 Private Enterprise 172 50 The number of municipal flats and houses erected since the war is Borough Council 3,803 London County Council 2,860† 29 rebuilds from war damage The total number of dwellings (i.e. flats and houses separately assessed) in the Borough at the end of the year was 46,853 Legal Proceedings Date Address Magistrate's Decision 5.12.61 18, Halton Road. Housing Act, 1957. Section 27(1). Occupation of front and back basement rooms in contravention of terms for Closing Order. Case proved. Bench awarded defendant absolute discharge. 5.12.61 497, Liverpool Road. Housing Act, 1957. Section 27(1) Occupation of lower front room, contrary to terms of Closing Order. Case proved. Bench awarded defendant absolute discharge. Defendant ordered to pay Council £4. 4s. 0d. costs. Housing Act, 1957 During the year the following actions were taken: Section 9 (Repair of insanitary houses) Inspections — Visits — Section 16 (Individual unfit houses) Inspections, Visits and Re-visits 1,596 Houses represented 36 Undertakings accepted — Undertakings cancelled upon completion of work 1 Section 17 (Individual unfit houses) Closing Orders made 21 Demolition Orders made 1 Houses demolished 29 Section 18 (Parts of buildings including basement rooms) Inspections, Visits and Revisits (a) Basement Rooms 872 (b) Other parts of buildings 65 Representations made (a) Basement Rooms 33 (b) Other parts of buildings 4 Closing Orders made (a) Basement rooms 28 (b) Other parts of buildings 3 Undertakings accepted (other parts of buildings) 1 Undertakings cancelled or part cancelled upon completion of work (basement rooms) 3 51 Section 27 Closing Orders determined or part-determined upon completion of work in respect of (a) Whole houses 36 (b) Basement rooms 38 (c) Other parts of buildings 2 Section 36 (Houses let in lodgings-securing fitness for occupation by number of families accommodated) Inspections, Visits and Re-visits 42 Report to Committee 4 Notices complied with 1 Section 90 (Houses let in lodgings-overcrowding) Inspections and Revisits 15 Reports to Committee 2 Overcrowding abated — Section 42 (Clearance Areas) Inspections 78 Re-visits 520 Housing Consolidated Amendment Regulations, 1932. (House to House Inspections) Number of inspections 82 Number of Visits & Re-visits 18 Housing Subsidies Act, 1956, as Amended by Housing (Financial Provisions)Act,1958. Certificates of unfitness issued in respect of certain Municipal properties Individual houses 9 Housing Act,1949 Improvement Grants Inspections, Visits and Re-visits 138 Town and Country Planning (Housing Accommodation) Direction 1952. In accordance with this direction the Council is consulted by the London County Council before consideration is given to applications received for a change of user from a dwelling to another purpose. In this connection 13 investigations were carried out by this Department. Licences Authorising Temporary Overcrowding No licences were issued during the year. Repair Conversion Visits 431 Council Purchase Visits 225 52 SECTION E SUPERVISION OF FOOD (In conjunction with Mr. W.C. Bartlett, Chief Public Health Inspector) No major legislation was made during the year. Certain Regulations were made, however, including:- The Labelling of Pood (Amendment) Regulations,1961 The Lead in Pood Regulations,1961. The Ministry of Health and the Ministry of Agriculture, Fisheries and Pood, jointly issued Food Hygiene Codes of Practice No.5, which deals with Poultry Dressing and Packing. The Council appointed Councillor L. Ross as delegate to attend a meeting of the Association of Public Health Inspectors when a discussion entitled "Present Day Food" was held. Approval was given for three Inspectors to attend a Refresher Course in meat inspection given by the Food Commodities Department of the College for the Distributive Trades. The course was held during the evenings and consisted of 18 lecture-demonstrations. A number of night inspections were carried out by certain Inspectors concerned with the supervision of refreshment houses, delivery of milk to retailers and the transit of • meat. Complaints of alleged unfitness were received in respect of the following:- Black particles in bread Bread affected with black mould Bristle in loaf Buttered rolls containing margarine Dirty milk bottles Discoloured bread Fly in bread Foreign substance in loaves Foreign substance in sausage Foreign substance in bottle of milk Foreign matter in orange drink Foreign body in bottle of vinegar Glass in milk Insect in sugar Insect in wrapped loaf Larval webbing in bread crumbs Maggots in bacon Maggots in chocolate Metal in tin of peas Metal chain in bottle of milk Metal caps in bottle of milk Metal in bread Mice droppings in toffee Mildew in Danish pastry Moth larvae in shredded wheat Mould in meat balls Mould in sausage rolls Mould in fruit tarts Mould spores in orange drink Mould in cake Mould in Battenburgh cake Orange drink Pin in bun Pork pies Sheep's head Stale fried fish Tainted lemonade Tin of frankfurters Tobacco in bread roll Uncooked dough in cake At two addresses in the Borough food was seized by the Inspector and a Magistrate's Order obtained for it to be destroyed as unfit for human consumption. Details of the prosecutions in respect of certain of the above complaints and action of the Inspectors appear on pages 55 and 56. Those responsible for the preparation, storage and sale of food usually maintain a high standard of hygiene; in fact quite a number carry out much more than may be legally required. There remains, however, a hard core of those whose premises and personal hygiene fall very far short of what is desired and much of the Inspector's time is taken up in an endeavour to secure a reasonable standard. The Inspectors seek by personal talks to the Management and staff concerned to show what can be done at the respective premises with oftentimes little outlay and with the materials available. It is not easy to convince some that the basis of hygienic conditions is often soap and water, and premises which are brought up to a standard which complies with the Regulations very often are allowed to fall back to 53 their original condition unless the Inspector keeps them under continual serveillance. In certain cases legal proceedings have been resorted to and a list of prosecutions under the Pood Hygiene Regulations can be found on pages 55 and 56. The influx of immigrants into the Borough has resulted in an increase in the Inspector's work. Many are not conversant with the English language and the service of an interpreter has often to be sought. An interesting case arose when a representative from a large retail premises in the Borough telephoned the Inspector concerning a number of complaints which he had received concerning the flavour of cut chicken. He had not at first felt it important to bring it to the attention of the Department but complaints continued to be received, including a number in regard to meat, sold from this establishment, which had been kept in the refrigerator with the cartons of cut chicken. There was certainly a strong smell in the refrigerator and the Manufacturer's engineer was contacted. An inspection of the equipment proved negative and the refrigerator plant found to be entirely satisfactory. The smell persisted however, and further investigations were carried out, during which, a carton of cut chicken was opened. The smell, similar to T.C.P. was at once noticed. Further investigation revealed that the trouble was due to the introduction of 6-ortho-chloro-cresol in the glue of the carton adhesive. It was necessary for all the meat and cut chicken which had been kept in this particular refrigerator to be disposed of for purposes other than human or animal consumption, the total value being quite considerable. Imported horse meat from the Argentine was the cause of some concern during the year and in conjunction with the Port Health Authority samples were taken. A procedure has been agreed between that Authority and the Borough Public Health Department so that after examination and sampling at the Port, the meat is either released as fit for human consumption or alternatively for sterilisation during manufacture into animal food. In conjunction with the Central Health Laboratory, Colindale, a detailed inspection of the premises concerned in the Borough and the technique adopted by the Company was carried out. Samples were taken at respective stages in the manufacture of animal food to ascertain whether the sterilisation process was satisfactory. Advice was given to ensure that no subsequent contamination was allowed to occur. Improvements in the technique were adopted by the Management who were most co-operative. Food and Drugs Act, 1955. Number of food prealses In the area, and type of business Bakehouses... level 26 " - basement 9 Bakers' retail shops 65 Butchers 150 -Continental 1 Cafes and Restaurants 249 Canteens and Clubs 116 Chemists 60 Coffee stalls 2 Continental Food Shops 44 Fish shops 33 ,, curers 22 " depot 1 " friers 51 Food factories 40 Food stalls 79 Food storage premises for street traders 66 Greengrocers and Fruiterers 178 Grocers and Provision merchants retailers 507 " " " " wholesalers 20 Licensed "Clubs" 37 Off-licences 102 Public Houses 275 Beerhouses 5 Sugar and chocolate confectionery 406 Milk machines 21 Food machines 5 54 Preserved Food Premises Registered under Section 16 (1) (b) of the Food and Drugs Act,1955 (Included in foregoing list) Total No. of Preserved Food premises 175 No. of Butchers 120 No. of Grocery and provision shops 39 No. of Food Factories 11 No. of Cooked meat shops 1 No. of Jellied Eels and Pie Shops 2 No. of Bakers (meat pies) 2 Total No. of inspections and visits made by Inspectors to Preserved Food Premises 483 Details of the inspections etc. by the Inspectors are given below: Bakehouses-level 83 " - basement 104 Bakers (bread and cake shops) 144 Butchers 359 Confectioners 209 Fried fish shops 176 Fish curers 88 Fishmongers 8 Greengrocers & Fruiterers 88 Grocery & Provisions 778 Wholesale Food Stores and Depots 104 Markets 84 Food Storage for Street traders 21 Other Food Premises 287 Vehicles 98 Stalls 122 Public Houses and Off Licences 7 Restaurants, Eating Houses and Canteens 1,164 Meat inspections at Licensed Slaughterhouse 301 Food examinations (other) 513 Ice Cream premises 360 Preserved Food Premises 483 Dairies (milk distributor) 520 Contraventions found 1,271 Contraventions remedied 1,209 Notices served (Food and Drugs Act) 276 Notices complied with (Food and Drugs Act) 289 Infectious diseases 15 Food poisoning enquiries 15 General Legal proceedings-attendances at Court 35 Non-effective visits 233 1,159 Legal Proceedings Details of the action taken by the Council under the Pood and Drugs Act, 1955, and the Pood Hygiene Regulations made thereunder are as follows:- 55 Date Offence Magistrate's Decision (1) 3.1.61 Food and Drugs Act, 1955. Section 2 (1) Selling food, namely a bottle of cream soda not of quality demanded at 165 Upper Street Food and Drugs Act, 1955. Section 2 (1) Fined £2. 0s. 0d. Defendant to pay £3, 3s. 0d. costs. (2) 3.1.61 Selling food, namely a half pint of milk not of the quality demanded at 32 Drayton Park Fined £.5. 0s.0d. Defendant to pay £5. 5s. Od. costs. (3) 3.1.61 Food and Drugs Act, 1955. Section 2 (1) Selling food namely a pint of milk not of the quality demanded at 41 Huntingdon Street Food and Drugs Act. 1955. Section 8 (l)(a) Fined £5. 0s. 0d. Defendant to pay £5s. 5s, 0d. costs. (4) 7.2.61 Having in possession for the purpose of sale or preparation for sale, food, namely one tin of cheese, one small barrel of mackerel, one part tin wine leaves, a quantity of olives, a quantity of smoked herrings, a small forequarter of lamb and a quantity of vegetables, intended for, but unfit for human consumption at 107 Upper Street. Food Hygiene (General) Regulations, 1960. Regulation 5. Fined £25. 0s. 0d. Defendant to pay £3. 3s. 0d. costs. (5) 7.2.61 Insanitary food premises at 107 Upper Street Food and Drugs Act, 1955. Section 8 (1) (d) Fined £10. 0s. 0d. (6) 2.5.61 Having in possession for the purpose of sale, or preparation for sale, food, namely nine meat balls, intended for but unfit for human consumption at 237 Holloway Road. Food Hygiene (General) Regulations, 1960. Regulation 5. Summons dismissed. (7) 6.6.61 Insanitary food premises at 6 36 Holloway Road Food and Drugs Act, 1955. Section 8(l)(a) Fined £5. 0s. 0d, Defendant to pay £2 2s. 0d. costs. (8) 4.7.61 Having in possession for the purpose of sale, food, namely three small pork pies intended for but unfit for human consumption at 364, Hornsey Road. Food Hygiene (General) Regulations, 1960. Regulation 5. Fined £1. 0s. 0d. Defendant to pay £2. 2s. 0d. costs. (9) 4.7.61 Insanitary food premises at 110 Upper Street. Food Hygiene (General) Regulations, 1960. Regulation 16 (1). (2 summons) each defendant fined £3. 0s. 0d. The Council awarded £1 ls.0d. costs. (10) 4.7.61 Failing to provide suitable and sufficient wash-hand basins to all persons engaged in the handling of food at food premises at 110, Upper Street. Food Hygiene (General) Regulations, 1960. Regulation 5. (2 summons) Each defendant fined £2.0s.0d. The Council awarded £1. ls.0d. costs. (11) 4.7. 61 Insanitary food premises at 31/33 Highgate Hi11. Food and Drugs Act, 1955. Section 8(l)(a) Fined £2. 0s. 0d. Defendant to pay £1. ls.0d. . costs. (12) 5.9.61 Selling certain food, namely a sausage roll intended for but unfit for numan consumption at 75 Elthorne Road. (2 summons) Each defendant fined £1.10s.0d. Defendants to pay £5.5s.0d. costs plus witnesses' expenses of £2. 8s. 0d. 56 Date Offence Magistrate's Decision (13) 5. 9. 61 Food and Drugs Act, 1955. Section 2 (1) Selling food, namely a pint of milk not of quality demanded at 15 Cornwallis Road. Food and Drugs Act, 1955. Section 2 (1) Fined £.5. 0s. 0d. Defendant to pay £5.5s.0d. costs plus witnesses' expenses of £1. 16s. 0d. (14) 5. 9. 61 Selling food, namely two buttered rolls not of quality demanded at 162 Seven Sisters foad. Food Hygiene (General) Regulations, 1960. Regulation 8a. Fined £2. 0s. 0d. Defendant to pay £4.4s.0d. costs. (15) 19. 9. 61 Failing to take all steps as may be reasonably necessary to protect food from risk of contamition at 35 Sonning Street. Food Hygiene (General)Regulations, 1960. Regulation 22(1) Fined £5. 0s. 0d. Defendant to pay £3.3s.0d„ costs. (16) 19. 9. 61 Using a sleeping place as a food room at 35 Sonning Street. Food Hygiene (General) Regulations, 1960. Regulation 5. Case proved. Summons endorsed - ''no separate penalty". (17) 5. 12. 61 Insanitary food premises at la,Camden Walk. (16.6.61). Food Hygiene (General) Regulations, 1960. Regulation 5. Insanitary food premises at la, Camden Walk. (10.8.61) Summons against one defendant not proved. Other defendant fined £2.0s.0d. and to pay £l.is.0d, costs. Summons against one defendant not proved. Other defendant fined £2.0s.0d. and to pay £l.ls.0d, costs. (18) 5. 12. 61 Food Hygiene (General) Regulations, 1960. Regulation 5. Insanitary food premises at 198, New North Road. Regulation 16 (2) Failing to provide and maintain for a washhand basin at 198, New North Road an adequate supply of either hot or cold water. Regulation 19 (1)(b) Failing to provide and maintain for a sink at 198, New North Road an adequate 3upply of hot water at a suitably maintained temperature Cases against defendant proved. Absolute discharge awarded. Defendant to pay Council £3. 3s. 0d. costs. Unsound Food During the year 64 complaints of unsound food were received. The total amount of food condemned was:— Description Tons Cwts. Qtrs. Lbs. Tinned goods 16 2 0 20 Meat 13 15 3 25 fish 25 12 0 18 Poultry — 6 1 12 Others 2 11 10 TOTAL 58 7 3 19 57 1,643 condemnation certificates were issued, and 601 inspections were necessary in connection with this work, Condemned food received from traders is either taken to the Council's refuse disposal depot at Ashburton Grove, awaiting conveyance, under supervision, to the refuse tip or is dyed in order to make it impossible for it to be re sold or used for human consumption. Condemned meat is used for animal feeding or industrial purposes. Sampling 1961 465 samples (24 formal and 441 informal) were sent to the Public Analyst for examination. 52 of these samples, or 11.18, were adulterated, as shown in the summary below. It should be noted that a number of adverse reports relate to samples not taken during routine sampling but which were subject of complaint. Formal Nil Informal Brought forward 26 Bacon 1 Ham Sandwich 1 Bread 11 Kup Cakes 1 '' Crumbs 1 Lemonade 1 '' Rolls 2 Milk 8 Brine 1 Nut Toffee 1 Buns 2 Orange Drink 3 Buttered Rolls 1 Pork Pie 1 Cane Sugar 1 '' Sausages 3 Cake 1 Sandwich Mixture 1 "mixture 1 Sausage Rolls 2 Chocolate cream 1 Sponge Mixture 1 Currant Bun 1 Tarts 1 Danish Pastry 1 Shredded Wheat 1 Pried Fish 1 Vinegar 1 Carried forward 26 52 Meat and Other Foods No visits by officers of this department were made during the year for the purpose of inspecting home killed or imported meat at the Metropolitan Cattle Market. In accordance with the requirements of the Public Health (Meat) Regulations, 1924/52, notices were received during the year in respect of the intended slaughter of animals for human consumption. Details of action taken are as follows:- Cattle Excluding Cows Cows Calves Sheep and Lambs Pigs Horses Number killed (if known) 193 1,004 56 84 - 800 Number inspected 193 1,004 56 84 - 800 58 Cattle Excluding Cows Cows Calves Sheep and Lambs Pigs Horses All diseases except Tuberculosis & Cysticerci Whole carcases condemned 3 45 3 24 — — Carcases of which some part or organ was condemned 24 565 2 12 — 78 Percentage of the number inspected affected with disease other than tuberculosis and cysticerci 13.9 60.76 8.92 42.85 - 9.75 Tuberculosis only Whole carcases condemned — — — — — — Carcases of which some part or organ was condemned - 1 — — — — Percentage of the number inspected affected with tuberculosis - .09 — — — — Cysticercosis Carcases of which some part or organ was condemned — — — — — — Carcases submitted to treatment by refrigeration — — — — — — Generalised and totally condemned - - — — — From the above table it will be observed that the incidence of tuberculosis is extremely low. This is due to the eradication of tuberculosis programme being carried out by the Ministry of Agriculture, Fisheries and Food. There was one case of generalised Xanthosis. Three carcases affected with Cysticercus Bovis were received from another area and treated by refrigeration under the supervision of the Inspector concerned. After being kept at a temperature below 14°F. for a period of not less than 3 weeks, they were released. All diseased or unfit meat was disposed of for use as knacker's meat or in the manu facture of all animal feeding preparations. Of the 800 horses slaughtered forehuman consumption, 686 were intended for export. Slaughter of Animals Act, 1958. Slaughtermen's Licences During the year one new Licence was issued, and ten Licences were renewed and were current at 31st December. Export Certificates - Food 24 Export Certificates were issued. The food consisted mainly of tinned and bottled meats (boneless chicken, ox tongue, ham, etc.), soups, ox tongue and ham spreads. The majority of the food went to Canada (8) U.S.A. (7); other countries were Australia (2) Saudi Arabia (2), Trinidad (2), Jordan (1), Portugal (1), and Sweden (1). Merchandise Marks Act, 1887/1933 Agricultural Produce (Grading and Marking) Act, 1928/31 Routine inspections are carried out by Inspectors to ensure compliance with the requirements of these statutes, details of which are as following:- 59 Merchandise Marks Acts. Inspections 28 Contraventions found - Contraventions remedied - Agricultural Produce (Grading and Marking) Acts. Inspections 2 Contraventions found - Inspection of Refreshment and Coffee Stalls Evening inspections of refreshment and coffee stalls were carried out by Public Health Inspectors as found necessary. No complaints relative to such stalls were received during the year, and the conditions found to exist at the time of the Inspectors' visits were generally satisfactory. Free lashing Facilities In Public Conveniences The Council continued to provide free washing facilities in public conveniences in order to encourage cleanliness amongst food handlers and, particularly, street traders who have no convenient personal facilities. The following table given through the courtesy of the Cleansing Superintendent provides details of the weekly average number of persons who availed themselves of the Council's facilities. Traders are becoming more aware of these facilities, the number of persons taking advantage of them being on the increase. Convenience Jan. Feb. Mar. Apr. May June Jul. Aug. Sept. Oct. Nov. Dec. Approx. weekly average throughout year Finsbury Park Men 61 55 63 64 60 81 71 84 90 70 65 55 68 Women 39 46 29 32 50 60 31 43 47 45 40 35 41 Parkhurst Road Men 112 103 97 119 122 124 102 113 127 31 50 25 94 Women 49 48 53 100 112 105 87 92 91 142 182 210 106 Archway Men 101 97 102 65 72 79 62 71 80 40 45 35 71 Women 43 52 49 55 68 64 54 57 58 75 75 75 60 Highbury Men 26 28 23 43 40 35 61 59 72 71 70 57 49 Women 22 31 24 35 52 87 38 41 44 56 36 32 41 Offord Road Men 9 12 13 11 13 15 12 15 19 30 27 25 17 Women 7 11 10 12 17 18 13 18 15 17 18 22 15 High Street Men 64 33 62 61 68 74 70 81 82 31 41 40 59 Islington Green Women 11 15 12 17 16 14 18 22 21 19 18 18 17 544 541 537 614 690 756 619 696 746 627 667 629 60 Ice Cream. Ice Cream (Heat Treatment, etc.) Regulations, 1959. Supervision of the Manufacture and Distribution of Ice Cream. During the year 360 visits were paid to ice cream premises and vehicles. The number of premises registered:- (a) for manufacture, sale and storage 7 (b) for sale and storage 387 (c) for sale only 162 (d) for storage only 1 557 1. Bacteriological Examination (a) Ice Cream Twenty samples of ice cream were sent for bacteriological examination and following Methylene Blue tests were graded as follows:- Grade I 12 Grade II 3 Grade III 2 Grade IV 3 20 Samples falling within Grades I or II are considered satisfactory It was found that in premises registered for the sale and storage of ice cream, the proprietor in conjunction with other business carried on in the shop, stored and sold live maggots and brandlings. Cancellation of the registration followed after the legal formalities required by the Food and Drugs Act, 1955,had been complied with. Premises where paraffin is stored and sold are not usually considered suitable for registration under section 16 of the Pood and Drugs Act, 1955. The choice of storing and selling paraffin or ice cream is one for the applicant and in a number of cases the trade in paraffin ceased. (b) Lollies Number sampled Satisfactory Unsatisfactory Cream Lollies 14 14 — Plain Lollies 14 14 — 2. Chemical Examination Ice Cream 18 18 Ice Lollies 22 22 Details of 18 samples of ice cream examined for fat content are as under:- 6% 7% 8% 9% 10% 11% 12% 13% 14% 15% 1 4 4 1 3 2 1 - 2 - 61 Milk Samples 1. Bacteriological Examination Class of Milk Results Phosphatase Methylene blue Turbidity Biological Total Number of Samples Pasteurised Satisfactory 24 24 — — 24 Unsatisfactory — - — - Sterilised Satisfactory — — 12 — 12 Unsatisfactory — — — — Tuberculin Tested (Pasteurised) Satisfactory 13 13 — — 13 Unsatisfactory — — — — Tuberculin Tested (Raw Milk) Satisfactory — 7 — 7 19* Unsatisfactory — 3 — — TOTAL 68 *2 Samples void-atmospheric shade temperature exceeded. ¢Two animals died Certain milk obtained from a farm in another area was found to be bacteriologically contaminated.. The dairy which was responsible to deliver this milk to customers in the Borough co-operated and ceased to deliver until the circumstances had been thoroughly investigated and it was considered safe to release it. Due to the wide distribution of this milk other metropolitan areas were also affected. It was considered that the adverse reports pointed to the holding time at weekends after cooling and before bottling and delivery Regular sampling of the milk from this source is still being carried out. 5. Chemical Examination Details of samples submitted Satisfactory Unsatisfactory Total Formal 4 • 4 Informal 113 s 7 120 124 Milk (Special Designation) Regulations,1860. Number of Licences in force 359 Milk and Dairies (General) Regulations,1959 Number of Dairies registered in the Borough 14 Number of Distributors registered in the Borough 343 62 SECTION F MISCELLANEOUS SERVICES HEALTH PUBLICITY AND HEALTH EDUCATION Home Safety Act 1961 The above Act, which came into operation on 18th May, 1961, empowers the Councils of County Districts and Metropolitan Boroughs to promote home safety by giving information and advice on the prevention of accidents in the home, and to contribute to national and local non profit making organisations whose activities include the promotion of home safety Section 2 of the Act repeals section 2 of the London County Council (General Powers, Act, 1957, which empowered Metropolitan Boroughs to promote home safety activities, since the power has now been restated nationally. It was under the 1957 Act that the Islington Home Safety Committee was set up in 1958, Islington Borough Home Safety Committee Membership as at 31st December. 1961 Honorary President : His Worship the Mayor, Alderman L R Webster J.P. Chairman : Alderman A. J. Rogers Vice Chairman : Mr, J. Capsey Honorary Secretary : Dr. V, Freeman Councillor Mrs. A. Seeley Islington Borough Council - Estates Committee Councillor Mrs. B. Stradling " " " - Housing Committee Councillor H.J, Reid " " " - Public Health Committee Dr. Wilfrid G Harding London County Council - Health Division 3 Mr. S R, Butcher " " " - Housing Department Chief Officer's representative " " " - Fire Brigade Mr I W Winchester, F. R,C. S. Archway Group Hospital Management Committee Councillor Mrs. E E Bull, L.C.C. " " " " " Mr. J., Capsey Northern Group Hospital Management Committee Mr W.J. Palmer " " " " " Dr. E Colin-Russ Local Medical Committee for the County of London Miss D. E. Church Islington Old People's Welfare Council Mr H.E.F. Heath North Thames Gas Board Mr L. C. Atkins London Electricity Board Mr D.J Cooper London Master Builders' Association Mrs. A. Griffiths Islington Trades Council (1953) Miss B. Naish Royal Society for the Prevention of Accidents, Four ordinary meetings of the Committee were held during the year. Three speakers were invited to give talks on various aspects of accident prevention, and on one occasion, Members of the Committee were invited to visit the Headquarters of the London Ambulance Service, where a most interesting and informative demonstration of the work of the Accident Service was arranged by the County Council's staff. 63 The three guest speakers were:- Mr. Richardson, London Ambulance Service, who spoke on the Work of the Service, Dr. E G. M. Palser, Senior Casualty Officer, Royal Northern Hospital, whose subject was "Home Accidents as viewed from a Casualty Department" Mr. L.L. Hughes, A M.I.E.E,, of The British Electrical Development Corporation, who contributed ' "Further Thoughts on Electrical Home Safety''. In view of the demand, a reprint became necessary of the handbook, ' 'Sense About Safety'', which was produced in conjunction with the "Safety in the Home' Exhibition last year. This handbook was based on a series of talks previously given to the Home Safety Committee, and it is hoped that it will be possible to arrange for the production of a second handbook in due course, A compliment to our present handbook was paid by Holborn Borough Council who requested permission to reproduce the book for their own Home Safety exhibition. A considerable number of items were placed before the Committee during the year, and the following may be of general interest. Dr. Harding, Division Medical Officer, L.C.C. Health Division 3, reported his action relating to an advertisement issued by a well-known firm of water heater manufacturers showing a baby in a bath of steaming water, with a water heater depicted as directly over the bath. He pointed out that this advertisement might well convey a suggestion to some that babies' baths, with babies inside them, could be filled in this way. As a result of the correspondence, the advertisement was modified and, it is understood, has since been withdrawn altogether The Home Safety Committee recommended to the Public Health Committee the provision of Pension Book Wallets, appropriately overprinted with home safety slogans, for free distribution to pensioners in the Borough 3,000 were obtained and distributed by this Department's visitors, the Islington Old People's Welfare Council and the Women's Voluntary Service, as well as from the Town Hall Information Office The Committee gave much thought also to the subject of fires caused by oil heaters. The London Fire Brigade Committee reported exceptionally heavy incidence of such fires in North and South-west Islington, where the risk was approximately 65 per cent. above the County average. Public Health Inspectors made enquiries of dealers in the Borough regarding facilities for modification of existing heaters not. complying with British Standard requirements, and also assisted in the distribution of a leaflet look After Your Oil Heater', which was widely circulated to users of oil heaters both by the County and Borough Councils. A resume of Dr. Palser's talk to the Home Safety Hommittee on the many types of accidents seen in a Hospital Casualty Department was circulated for the information of all family practitioners in the Borough Inspectors also made enquiries as to the availability of flame-resistant clothing in Islington's shops. Unfortunately it was found that such materials were not generally available, and shopkeepers attributed this to lack of public interest, It is to be hoped that more recent publicity will prove effective in increasing both supply and demand. Among home safety posters and leaflets distributed through the Public Health Department, the Committee requested that special attention be paid to one entitled "Plastic Bags-a Danger to your Child", and this was gladly done by this and other Departments of the Council. Borne Accident Cases reported by the London Ambulance Service London County Islington No. of cases Rate per 10,000 population No. of cases Rate DOT 10,000 population Year ended 30. 9. 59 7708 24.1 654 29.3 ,, ,, 30.9.60 7757 24.3 588 26.4 ,, ,, 30.9.61 8341 26.1 700 31.4 64 National Fire Prevention Week In place of the London County Council's annual Home Safety Week, arrangements were made by the Fire Protection Association and the Royal Society for the Prevention of Accidents for a National Fire Prevention Week to be held from 30th October to 4th November. The Public Health Department co-operated in this campaign by arranging for the display of posters throughout the borough and distribution of leaflets and bookmarks from its own offices and other departments of the Council, and a specially prepared display stand supplied by the London Fire Brigade was placed in the entrance hall of the Town Hall. Lectures and Talks During the year the Medical Officer of Health gave a lecture on "Environment and Health" to the North London Association of Ophthalmic Opticiams, and also addressed a meeting of the Rotary Club of Islington on the subject of home safety; the Deputy Medical Officer of Health gave a series of lectures to a girls' youth club, addressed a special meeting of St. John Ambulance Brigade, and also gave talks to various old persons' and adult clubs, all on home safety. Conferences and Courses The Congress of The Royal Society of Health, in April, was attended by Councillor Hyde and the Medical Officer of Health. The Chairman of the Public Health Committee, with the Chief Public Health Inspector, attended the Association of Public Health Inspectors' Annual Conference in September; and Councillor Ross and the Medical Officer of Health represented the Council at the London and Home Counties Clean Air Advisory Council. Members of the Public Health Department staff attended the following courses:— Week-end School (Association of Public Health Inspectors) Rodent Control (One day) Refresher Courses (Ministry of Agriculture, Fisheries and Food) Refresher Course in Meat Inspection (College for the Distributive Trades) General Regular publicity by means of leaflets and posters, changed according to season and ???picality, together with the distribution of 1,000 copies per month of "Better Health" mainly through the Islington Public Libraries, and the provision of "Family Doctor" for reading, continued throughout the year. The outbreak of diphtheria in February, referred to on page 21, received considerable attention in the national press, as well as locally, and it became necessary to issue information regularly to the newspapers until the outbreak had subsided. SERVICES FOR ELDERLY PERSONS All those engaged in the health and welfare services for elderly persons, whether officers of the County or Borough Council, or voluntary workers, have found much to occupy them during the year. In the voluntary sphere, acknowledgements are due to the sustained interest and efforts of Miss D.E. Church, Honorary Secretary, and the Islington Old People's Welfare Council, and to Mrs. E. MacGregor, M. B E., the Centre Organiser, and members of the Women's Voluntary Service. The visiting of elderly persons carried out by the Public Health Department has again been a useful means of keeping in touch with many lonely old folk and arranging for various services and amenities to be provided for them where necessary. The Old Persons' Register maintained in the Department now contains some 3,000 names out of a total of 30,000 of pensionable age in the Borough. Two Public Health Inspectors Six Rodent Operators Three Public Health Inspectors 65 Mrs. A. E. Poster, who for the past five years had been Old Persons' Health Officer in the Borough, resigned her appointment in September, and Mrs. I. Milbank, her successor, took up her duties in November. At the same time, in view of the increasing need for visiting of the elderly in the Borough, a departmental re-arrangement of duties of domiciliary visiting staff, permitted more time to be devoted to this service The health officers visited 427 new cases during the year, and re-visits totalled 4,128. Apart from the provision of laundry and home bathing services, where appropriate, 3,414 references were made outside the Department. These references covered requests for provision of meals, and home help service, welfare home and/or hospital admission; grants from the National Assistance Board; introduction to clubs, Work Centre and associations dealing with blind and handicapped persons; registration with a medical practitioner and contacting relatives. Gas and Electricity undertakings were notified of any defective appliances and recommendations were made for the provision of fireguards by the London County Council in 60 cases this provision is invaluable in preventing accidents to the elderly from open fires Items of home nursing equipment were supplied by the County Council in 138 cases, on recommendation. The Borough Council grant to the Old People's Welfare Council for the year, which is utilised mainly for the provision of meals, holidays, and part-time employment for the elderly, totalled £8, 375. Public Health (London) Act 1936 Section 122 Cleansing and Lanndry Service Heavy demands have also been made on the disinfecting and laundry unit at the Treatment Centre, the service provided being of great assistance in home and institutional nursing of the incontinent sick, as the following details will show. Islington residents: No. of recipients approved 190 No. of washings carried out 2,942 No. of articles cleansed 30,994 Home for Confirmed Invalids, Highbury Terrace The weight of laundry dealt with during the year was 3 tons 2 cwts. 0 qtr. 4½ lbs. Aged Pilgrims' Friend Society Home, Hazellville Road Recommendations are received from the Matron for inmates of the nursing home wing who are incontinent. The weight of laundry dealt with was 1 ton 18 cwts, 0 qtrs. 24½ lb. Holborn Borough Council The agreement whereby clothing and bedclothes of incontinent elderly persons in Holborn Borough can be dealt with at the Islington laundry has continued. During the year 713 washings, comprising 7,339 articles were carried out on behalf of 47 recipients. Stoke Newington Borough Council A similar agreement was entered into, as with Holborn Borough Council. During the year 277 washings, comprising 2, 548 articles, were carried out on behalf of 7 recipients. London Coanty Conncll (General Powers) Act 1953 Section 43 Cleansing of Elderly Persons The service for the personal cleansing of elderly persons is closely linked, as might be anticipated, with the soiled linen service mentioned above. Cleansing may be carried out either in the person's home, if unable to leave home, or alternatively at the Treatment Centre, Seven Sisters Road, where cases may be taken in the Department's special ambulance. i93 persons were thus assisted by the Department's nursing and bathing staff, and this entailed 1,168 home visits and 585 baths given at the Treatment Centre. The work is carried out under the supervision of the Nurse-in-Charge at the Treatment Centre. 66 National Assistance Acts, 1948 and 1951 It was necessary to invoke the procedure for the removal to suitable premises without delay in respect of four elderly persons, in accordance with the provisions of the National Assistance (Amendment) Act, 1951. An order under subsection (3) of section forty-seven of the National Assistance Act, 1948, for the removal of any such person as is mentioned in subsection (1) of that section may be made without the notice required by sub-section (7) of that section if it is certified by the medical officer of health and another registered medical practitioner that in their opinion it is necessary in the interests of that person to remove him without delay. Details of the statutory action taken are given in the following statement which has been compiled in the form required by the Ministry of Health. Aged and Infirm-Action taken under Statutory Powers Name and Age Reason for Council's Action Period Named in Order Type of accommodation to which removed Ultimate Result (1) (2) (3) (4) (5) Case No. 1 Mr. L... 84 years Known to this Department for a number of years. Advanced Parkinson's disease. On discharge from hospital refused all services, relying solely on elderly wife. In April, 1961, a son removed his mother as the father was very difficult. By September, Mr, L. and his room were in very dirty condition but he still refused services. Following a visit by a Geriatric Physician, an ambulance was called to take him to hospital, but he refused to go. The Medical Officer of Health visited and concurred in the Geriatrician's opinion that Mr. L. should be removed to hospital, and application was accordingly made to a Justice of the Peace for an Order for his removal to hospital. Not exceeding three weeks Geriatric Hospital later transferred to Mental Hospital Died 21. 4. 62 Case No. 2 Miss H... 84 years Registered blind.person, rather deaf. Known to Department for a number of years. Received domiciliary services and medical attention, but unwilling to enter a Welfare Home. Special gas ring provided suitable for a blind person. By April, 1961 conditions had deteriorated, but Miss H. was adamant, in her refusal to enter Welfare Home or Hospital. ,She was visited by a Geriatric Physician and the Deputy Medical Officer of Health, who considered that compulsory removal was necessary and an application was there fore made to a Justice of the Peace for an Order for removal to hospital.. Not exceeding three weeks Geriatric Hospital Remained in Hospital. Case No. 3 Mrs. M... 82 years Mrs. M. was visited by the Health Officer following a report on 14th December, that she was wandering abroad in her nightdress. Mrs. M. was also visited by her doctor and a Geriatrician. .It was agreed that she needed hospital care, which she refused. She was again found wandering and taken to the Casualty Department of a local hospital, but refused admission. She was therefore seen in the Casualty Department on 15th Decembi by the Medical Officer of Health, who applied immediately to a Justice of thi Peace for an Order for her removal to hospital. Not exceeding three weeks er e Geriatric Hospital Died in Hospital 4 months after admission 67 Name and Age Reason for Council's Action Period Named in Order Type of accommodation to which removed Ultimate Result (1) (2) (3) (4) (5) Case No. 4 Mr. W. 79 years Following a request from relatives liying in Yorkshire, Mr. W. was visited on 7th December. He was in need of care but refused domiciliary services. His doctor requested admission tq a Welfare Home, but Mr. W. refused to go. Visited by the Medical Officer of Health, who confirmed insanitary cqqditions and Mr. W's need of care and.attention. As he was not receiving this and was in immediate need, application w^s made to a Justice of the Peace for an Order for his removal to a Welfare Home. Not exceeding three weeks Welfare Home Remained as permanent resident on expiration of Order Fortunately, in relatively very few cases is it necessary to apply for a Court Order for removal of elderly people under the National Assistance Acts. The following are just a few examples of the ways in which the Department's health officers are able to take action or ameliorate conditions on a basis of voluntary cooperation. Mrs. W. (83 years) A dirty and somewhat abusive lady,.visited for several years. Was persuaded to accept home bathing, and clothing was provided through the .National Assistance Board. Although there was temporary improvement, conditions deteriorated again and, after much persuasion, Mrs. W, entered a Welfare Home in December, Mrs. F. (89 years) Mrs. F. had been a clean and active lady. She lived alone.in two top floor rooms. Holidays, home-help and National Assistance Board help were made available to her from time to time as necessary from 1954 onwards. In 1960, however, her health deteriorated and meals-on-wheels, laundry and home bathing services were instituted. A year later she entered a Welfare Home, but in view of failing health was transferred to hospital in November this year. Mrs. S. (?80 years) In December last year a neighbour drew attention to the circumstances of this lady. She persistently refused all help and advice either from the .health officer or her own doctor and even refused them admission. In February this year, a Public Health Inspector had occasion to visit the premises; he found curtains drawn and no.sign of Mrs. S. Neighbours had not seen her for several days. "Die Inspector, with the assistance of a Police Constable, forced entry and Mrs. S. was found dead, fully clothed on the bed. Her doctor was called and certified death. A search of the premises failed to reveal any clue as to relatives of the deceased. National Assistance Act, 1948, Section 31 ''Heals-on-Wheels'' and Lunch Clubs This Section of the Act permits Local Authorities to make contributions to the funds of any voluntary organisation whose activities include the provision of recreation or meals for old people. Grants were approved for "Meals-on-Wheels" services operated by the Women's Voluntary Service and the Islington Old People's Welfare Council. Meals supplied during the year were as follows:- Meals-on-Wheels Women's Voluntary Service 7, 071 16,678 meals cooked by NALGO, Town Hall Canteen Islington Old People's Welfare Council 5,428 Lunch Clubs Gifford Hall Mission Welcome Club 4,324 1,685 meals supplied by L.C. C. School Meals Service Caxton House Settlement 1,540 68 A lunch club at St. Giles Christian Mission, Bride Street. N.7., also produced 2,268 meals with the help of their own voluntary workers and Council grant-aid. Another lunch club, situated in the Borough of Pinsbury, at Claremont Central Mission, White Lion Street, also caters for Islington residents and receives a £50 grant from this Council. The purpose of the "Meals-on-Wheels" service is, of course, to supply meals to those elderly persons who are either housebound or have become so limited in their physical capacity that they cannot satisfactorily cope with all the necessary arrangements for the purchasing, preparation and service of food. This type of disability must necessarily increase with failing health, and the lack of sufficient supply of satisfactory food must in turn hasten health deterioration, so setting up a vicious circle. To break this circle or at least to delay its onset - is one of the objectives of the "Meals-on-Wheels" service. The provision of between 70 and 80 meals each day of the service is, of course, very useful and, since much of the work involved in the transport of meals is of a voluntary nature, the "Meals-on-Wheels" service does represent a very considerable voluntary effort. Nevertheless, the present service is limited because it is not possible, in general, to provide each elderly person recommended for a meal a delivery on more than two days a week. Prom the nature of the recommendations, there is no doubt the great majority, if not all, would benefit by the service being at least doubled to 4 meals, or possibly more, per week. This has not hitherto been possible, but it is certainly to be hoped that an increase of this order can be envisaged in the not too distant future. Holidays for Elderly Persons Assisted holidays were again much in demand, and 592 elderly people were able to enjoy a holiday through the Borough Council's grant-aided scheme, which is administered hy the Old People's Welfare Council. A sum of £2, 750 was earmarked to meet costs which pensioners could not be expected to pay. Most holidaymakers, however, were able to pay some of their expenses and Miss Church, Honorary Secretary of,the Welfare Council, arranged to collect small weekly sums to suit the convenience of the savers. Parcels for Elderly Persons The Borough Council authorised the expenditure of £50 on Christmas gift parcels, and it was possible to make a distribution to about a hundred elderly folk. The health officers recommended suitable recipients and delivery was arranged by the Islington Old People's Welfare Council. Islington Work Centre for the Elderly This is another social venture which has now become firmly established in Islington. Numbers attending the sessions have increased and the workroom is usually full to capacity, providing part-time employment for about 80 persons, each working five half-day sessions per week. The Centre is sited at the Elizabeth Whitelaw Reid Club, Cloudesle^ Street, N. 1., and Miss K.D. Lane, Centre Organiser, is responsible for the day-to-day business, while the Centre is run under the direction of a Sub-Committee of the Old People's Welfare Council. Generally speaking,, sufficient out-work was provided by application to local firms, and the old people were able to reach a high standard of efficiency in carrying out the various tasks. As well as giving them an added interest, a small monetary reward and an opportunity of meeting other elderly folk, the Work Centre is fulfilling a valuable purpose in helping to maintain in these retired people a sense of usefulness in the community. Chiropody The financial responsibility for this service, as reported last year, has now passed to the London County Council, but the local administration and appointments system are dealt with by the Islington Old People's Welfare Council, who run nine weekly sessions and make appointments for approximately 72 persons each week. In addition, a small number of infirm persons are attended in their own homes. 69 PUBLIC MORTUARY By agreement with the St. Pancras Borough Council the use of the Council's Mortuary was discontinued as and from 31st March, 1949, all bodies being received at the St. Pancras Mortuary, Cramley Street, N. W. 1., after that date. ISLINGTON CREMATORIUM The Medical Referee or the Deputy Medical Referee certified a total of 616 applications for cremation at the Council's Crematorium, East Pinchley. MATERNITY AND CHILD WELFARE SERVICES The London County Council, as the Local Health Authority, is responsible for the Maternity and Child Welfare Services, the Home Help Service and a foot clinic service in the Borough, which, together with the Boroughs of Finsbury and Holborn, constitute Division 3. I am indebted to Dr. Wilfrid G. Harding, Divisional Medical Officer, for the information given below in respect of these services:- Total Attendances at Maternity & Child Welfare Centres 0-1 years 50,396 1-2 years 6,237 2-5 years 4,092 Special Toddlers' Clinics 2,899 Ante-Natal and Post-Natal Combined. 16,230 Foster Mothers • The table of foster-mothers and foster-children registered under the Childrens Act, 1958, is as follows:- 31.12.1961 Number of persons fostering children 21 Number of foster-children being cared for 28 L.C.C. Day Nurseries and Child Minders At present there are 3 Day Nurseries open in Islington:- Scholefield Road 60 places Canonbury Place 67 " Mitford Road 67 " 194 There are also 50 places for Islington children in Springdale Day Nursery (Stoke Newington). In addition there were at the end of the year 127 children being minded by 105 child minders registered voluntarily under the L.C.C. scheme Nurseries and Child Minders Regulation Act, 1948 At the end of the year there were 60 children being minded by 21 child minders registered by the L.C.C. under the provisions of the Nurseries and Child Minders Regulation Act, 1948. There were also two private day nurseries registered under the Act providing 33 places. 70 Foot Clinics Foot clinics are provided at East Islington Welfare Centre at Drayton Park and South Islington Welfare Centre at Clephane Road for 'priority cases'-the aged, expectant mothers and the physically handicapped. During the year there were 6,234 and 1,767 attendances respectively. An additional foot clinic was started at the Junction Road Congregational Church on 2nd August, 1961 and total attendances there to the end of the year were 104 Many Islington residents attend the main foot clinic at Pine Street in Finsbury where the total attendances were 16,777. Home Helps The home help area is administered from three area offices in the Division. Each of the three areas covers part of Islington and together cover the whole Borough The total number of households in the Division receiving home helps on 31st December, 1961, was 1,872. 71 Maternity and Child Welfare Centres - The days and times of sessions are as follows:- CENTRE Ante-Natal & Post-Natal Children's Toddlers Dental Diphtheria Immunisation Poliomyelitis Inoculation Smallpox Vaccination North Islington Infant Welfare Centre, (Voluntary) Mon. 2 p.m. Wed. 2 p.m. (2nd in Mth. ) Wed. 1. 30 p.m. Wed. 2 p.m. Wed. 2 p.m. Wed. 2 p.m. 6-9 Manor Gardens, N.7 Tues. 1 10 a. m. Mon. to Frid. 2 p.m. * Hiurs. 10 a.m. (1st in Mth. ) Thurs 9. 30 a.m. & 1.30 p, m Frid, 10 a.m. Frid. 10 a.m. Frid, 10 a.m. Wed. Thurs Frid. Thurs. 5.30- Wed. 2 p.m. Frid. 2 p.m. 6.30 p.m. North Branch Clinic - Blythe Mansions, Hornsey Rise, N. 19 Frid. 10 a.m. Mond. 2 p.m. Thurs. 2 p.m. (3rd in Mth) Mon. 2 p.m. Mon. 2 p.m. Mon. 2 p.m. 2 p.m. Tues. 2 p.m. Tues. 2 p.m. Tues. 2 p.m. Tues. 2 p.m. North Branch Clinic - Co-operative Hall, 129, Seven Sisters Road, N.7. Wed. 2 p.m. Frid. 2 p.m. (1st in Mth.) Wed. 2 p. m. Wed. 2 p.m. Wed. 2 p.m. Archway M. & C. W. Centre - Congregational Church, Junction Road, N. 19 Tues. 2 p.m. Tues. 10 a.m. (Alt. Wks.) Tues. 2 p.m. Tues. 2 p.m. Tues. 2 p.m. Thurs. 10 a.m. & 2 p.m. Thurs. 10 a.m. & 2 p.m. Thurs. 10 a.m. & 2 p.m. Thurs. 10 a.m. & 2 p.m. West Islington Welfare Centre. 42 & 44, Richmond Avenue, N. 1 Tues. 10 a.m. Mon. 1 2 p.m. Mon. 11 a.m. Mon. 10 a.m. Mon. 10 a.m. ' Mon. 10 a.m. Tues. Thurs. 10 a.m. & 2 p.nh (midwives) Wed. Wed. 10 a. m. Wed. Wed. Wed„ / Frid. West Branch Clinic, Tenants' Clubroom, Hilldrop Estate, N.7 Frid. 10 a.m. Mon. 2p.m. Mon. 2 p.m. Mon. 2 p.m. Frid. 10 a.m. 2 p.m. (midwives) Mond. 2 p.m. Tues. 10 a.m. Tues. Tues. Tues. Tues. Wed. Wed. Wed. Wed. South Islington Welfare Centre. 6, Clephane Road, Essex Road, N. 1. Thurs. Thurs, Thurs. Thurs. Mon. 10 a.m. Mon. 2 p.m. Frid. 2 p.m. Thurs. 10 a.m. Thurs. 10 a.m. Thurs. 10 a.m. Tues. 2 p. m. (midwives) Tues. 10 a.m. Frid. 2 p.m. Frid. 2 p. m. Frid. 2 p.m. Thurs. Wed. 10 a.m. & 2 p.m. Frid. 10 a.m. Tues. 2 p.m. Tues. 2 p.m. Tues. 2 p.m. South Branch Clinic, Union Chapel, Compton Avenue, N. 1 Tues. 2 p.m. Thurs. Thurs Thurs.1 Thurs. East Islington Welfare Centre, 32, Drayton Park, N.5 Mon. 10 a.m. Tues. 2 p.m. Tues. 10 a.m. Mon. 2 p.m. Mon, 2 p.m. Mon. 3 p.m. Wed. 2 p.m. (midwives) Wed. 10 a.m. Frid. 2 p.m Frid. 2 p.m. Frid. 2 p.m. Frid, 2 p.m. & 5.30 - 6. 30 p.m. East Branch Clinic, 6, H'urlock Street, N. 5 Thurs. 2 p.m. Frid. 10 a.m. Tues. 2 p.m. Tues. 2 p.m. Tues. 2 p.m. Tues. 2 p.m. Wed, Wed. Wed. Wed. Thurs. Hiurs Thurs. Hiurs. INDEX Accidents 5,6,7,11,63 Acute Encephalitis 12 Acute Poliomyelitis 5,12,18-20,29 Aged and Infirm Persons 35,64-68 Ante-Natal Clinics 71 Anthrax 12,28 Atmospheric Pollution 36-40 Bacteriological Examination 29, 60,61 Births 3,6,8 Blow-Fly Infestation 36 Cancer-Lung 5,6,10,27 Certificates of Disrepair 32-33 Chemical Examinations 60 Child Minders 69 Child Welfare Centres 69,71 Chiropody for Elderly Persons 68,70 Clean Air Act, 1956 36-40 Cleansing, Elderly Persons 65 Closing Orders 50-51 Coronary Disease with Angina 11 Crematorium 69 Day Nurseries 69 Deaths 4-5,6,7,9-11,19,20,21,22,25 Dental Clinics 71 Diphtheria 5,12,20-22,29 Diphtheria Immunisation 21-22,71 Disinfection 35-36 Disinfestation 35-36 Disinfestation of Sewers 47 Dysentery 12,23-24,29 Elderly Persons, Services for 35,64-68 Encephalitis, Acute 12 Enteric Fever 12,29 Erysipelas 12 Export Certificates 58 Factories Act 41-43 Fly Infestation 36 Food and Drugs Act 53-57 Food Hygiene Regulations 55-56 Food - Inspection and Supervision 52-61 Food - New Legislation 52 Food Poisoning 12,22-23,29 Food Sampling 57 Food, Unsound 52,56-57 Foot Clinics 70 Foster Mothers and Children 69 Hairdressers & Barbers 45 Health Publicity and Health Education 62-64 Heating Appliances (Fireguards) Act, 1952 45 Holidays for Elderly Persons 68 Home Helps 65,70 Home Safety Committee 62-63 Home Visiting 12,28 Housing 49-51 Ice Cream 60 Illegitimate Infants - Births and Deaths 3,8 Infant Mortality 4,6,7,9 Infectious Diseases 12-29 Influenza, Pneumonia and Bronchitis 5,7,9,12 Inoculation, etc. Certificates 15 Laundry Services 65 Legal Proceedings 34-35, 43, 50, 55-56 Live Births 3,6 L.C.C. (General Powers) Acts 43,45 M. & C. W. Services 69-71 Malaria 12 Marriages 3,6 Mass X-ray 10,26-27 Maternal Mortality 4,6,9-10 "Meals on Wheels" 67-68 Measles 5,12,15,16,17-18 Meat 57-58 Meningococcal Infection 5,7,12 Merchandise Marks 58-59 Metropolitan Cattle Market 57 Milk 61 Milk and Dairies Regulations 61 Milk (Special Designations) 61 Miscellaneous Services 62-71 Mortuary 69 National Assistance Acts 66-68 Neoplasms, Malignant 5,6,10,27 Noise Abatement Act, 1960 43 Noise Nuisance 43 Nurseries-Day 69 Offensive Trades 44 Opthalmia Neonatorum 12 Outworkers 42 Overcrowding 51 Pet Animals Act 31 Pharmacy and Poisons Acts, etc. 45 Pigeon Nuisances 43-44 Pneumonia 5,7,9,12 Poliomyelitis 5,12,18-20,29 Poliomyelitis, Protection Against 19,20,71 Population 3,6,8-9 Post-Natal Clinics 71 Premature Infants 7 Preserved Food Premises 54 Prevention of Damage by Pests Act and Order 45-47 Public Health Committee 1 Public Health Inspectors-District Work 31-35 Public Health Inspectors-Special Work 41-45 Public Health (London) Act-Improvements effected 33 Public Health (London) Act, Sections 40 and 109 33-34 Public Health Officers 1-2 Public Health (Tuberculosis) Regulations, 1952 25-26 Publicity 62-64 Puerperal Pyrexia 12 Rag Flock and Other Filling Materials Act 45 Rats and Mice 45-47 Refreshment and Coffee Stalls 59 Pent Act, 1957 32-33 Respiratory Infections 5,7,9,12 Sampling 57,60,61 Sanitary Circumstances 30-48 Scabies 12,28 Scarlet Fever 12 Sewer Treatments 47 Smallpox 12,13-15,29 Smoke 36-40 Smoke Control Areas 36-37 Staff 1-2 Static Water Tanks, etc. 36 Statistics - General & Vital 3-11 Still-Births 3-6 Swimming Baths 48 Toddlers' Clinic 71 Town & Country Planning 51 Treatment Centre 28,65 Tuberculosis 5,6,7,10,12,25-28,29 Tuberculosis-Beds and Bedding 27 Tuberculosis-Care Committee 27-28 Tuberculosis-Chest Clinics 26 Tuberculosis-Deaths 5,6,10 Tuberculosis Notifications 6,12,25 Typhoid Fever 12,23 Underground Bakehouses 43 Vaccination 14-15,71 Vermin 12,28,35 Washing Facilities, Free 59 Water Supplies 47 Welfare Centres 69,71 Whooping Cough 5,7,12,15,17-18,29